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Risky anatomical variations of sphenoid sinus and surrounding structures in endoscopic sinus surgery

PURPOSE: This study aimed to examine the relationship between the sphenoid sinus (SS) and surrounding vital structures such as the internal carotid artery (ICA) and optic nerve canal (ONC) as well as the types of attachment of the sphenoidal septa onto these structures. METHODS: In total, 230 comput...

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Autores principales: Fadda, Gian Luca, Petrelli, Alessio, Urbanelli, Anastasia, Castelnuovo, Paolo, Bignami, Maurizio, Crosetti, Erika, Succo, Giovanni, Cavallo, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9440488/
https://www.ncbi.nlm.nih.gov/pubmed/36057720
http://dx.doi.org/10.1186/s13005-022-00336-z
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author Fadda, Gian Luca
Petrelli, Alessio
Urbanelli, Anastasia
Castelnuovo, Paolo
Bignami, Maurizio
Crosetti, Erika
Succo, Giovanni
Cavallo, Giovanni
author_facet Fadda, Gian Luca
Petrelli, Alessio
Urbanelli, Anastasia
Castelnuovo, Paolo
Bignami, Maurizio
Crosetti, Erika
Succo, Giovanni
Cavallo, Giovanni
author_sort Fadda, Gian Luca
collection PubMed
description PURPOSE: This study aimed to examine the relationship between the sphenoid sinus (SS) and surrounding vital structures such as the internal carotid artery (ICA) and optic nerve canal (ONC) as well as the types of attachment of the sphenoidal septa onto these structures. METHODS: In total, 230 computed tomography (CT) scans were reviewed to study the type of sphenoid sinus pneumatization (SSP), the protrusion and dehiscence of the ICA and ONC, the relationship between the sphenoidal septa and surrounding vital structures as well as pterygoid recess pneumatization (PRP). RESULTS: The most common SSP was sellar type (58.7%). The rates of protrusion and dehiscence of the ICA were 26.3 and 0.4%, and for the ONC, they were 13 and 1.5%, respectively. The ICA and ONC were most protruded and dehiscent in more extensive SSP. In 21.6% of patients, the intersphenoidal septa (IS) were attached to the wall of the ICA and in 8.6% they were attached to the wall of the ONC. The attachment of IS to the ICA correlated statistically significantly (p < 0.0001) with protrusion of the ICA. Accessory septa were detected in 30.4% of cases with various sites of attachment. CONCLUSION: To reduce the risk of injury and complications during endoscopic sinus surgery (ESS), surgeons should consider using CT to identify possible bulging and dehiscence of the ICA/ONC and their relationship to the extent of SSP and also to establish the presence of deviation of the sphenoid septum, and the presence of accessory septa.
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spelling pubmed-94404882022-09-04 Risky anatomical variations of sphenoid sinus and surrounding structures in endoscopic sinus surgery Fadda, Gian Luca Petrelli, Alessio Urbanelli, Anastasia Castelnuovo, Paolo Bignami, Maurizio Crosetti, Erika Succo, Giovanni Cavallo, Giovanni Head Face Med Research PURPOSE: This study aimed to examine the relationship between the sphenoid sinus (SS) and surrounding vital structures such as the internal carotid artery (ICA) and optic nerve canal (ONC) as well as the types of attachment of the sphenoidal septa onto these structures. METHODS: In total, 230 computed tomography (CT) scans were reviewed to study the type of sphenoid sinus pneumatization (SSP), the protrusion and dehiscence of the ICA and ONC, the relationship between the sphenoidal septa and surrounding vital structures as well as pterygoid recess pneumatization (PRP). RESULTS: The most common SSP was sellar type (58.7%). The rates of protrusion and dehiscence of the ICA were 26.3 and 0.4%, and for the ONC, they were 13 and 1.5%, respectively. The ICA and ONC were most protruded and dehiscent in more extensive SSP. In 21.6% of patients, the intersphenoidal septa (IS) were attached to the wall of the ICA and in 8.6% they were attached to the wall of the ONC. The attachment of IS to the ICA correlated statistically significantly (p < 0.0001) with protrusion of the ICA. Accessory septa were detected in 30.4% of cases with various sites of attachment. CONCLUSION: To reduce the risk of injury and complications during endoscopic sinus surgery (ESS), surgeons should consider using CT to identify possible bulging and dehiscence of the ICA/ONC and their relationship to the extent of SSP and also to establish the presence of deviation of the sphenoid septum, and the presence of accessory septa. BioMed Central 2022-09-03 /pmc/articles/PMC9440488/ /pubmed/36057720 http://dx.doi.org/10.1186/s13005-022-00336-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Fadda, Gian Luca
Petrelli, Alessio
Urbanelli, Anastasia
Castelnuovo, Paolo
Bignami, Maurizio
Crosetti, Erika
Succo, Giovanni
Cavallo, Giovanni
Risky anatomical variations of sphenoid sinus and surrounding structures in endoscopic sinus surgery
title Risky anatomical variations of sphenoid sinus and surrounding structures in endoscopic sinus surgery
title_full Risky anatomical variations of sphenoid sinus and surrounding structures in endoscopic sinus surgery
title_fullStr Risky anatomical variations of sphenoid sinus and surrounding structures in endoscopic sinus surgery
title_full_unstemmed Risky anatomical variations of sphenoid sinus and surrounding structures in endoscopic sinus surgery
title_short Risky anatomical variations of sphenoid sinus and surrounding structures in endoscopic sinus surgery
title_sort risky anatomical variations of sphenoid sinus and surrounding structures in endoscopic sinus surgery
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9440488/
https://www.ncbi.nlm.nih.gov/pubmed/36057720
http://dx.doi.org/10.1186/s13005-022-00336-z
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