Abstract
BackgroundThere are numerous variations reported regarding anatomy of the sphenoidal sinuses that include e.g. their pneumatisation, septation and relation to neurovascular structures. The following study aimed to examine the height of the MS in the sphenoidal sinuses, as well as its type (bony, membranous or mixed) and its course amongst the adult Polish population. Materials and methodsA retrospective analysis of 296 computed tomography (CT) images (147 females, 149 males) of the paranasal sinuses was conducted. Images in axial, coronal, and sagittal planes were visualised and analysed. ResultsThe average height of the MS was 2.1 ± 0.41 cm for the entire research group. Completely bony MS was found in 32.77% of the patients, partially membranous in 63.85%, and solely membranous in 3.38% of the patients. The course of the MS that changed from the anterior to the posterior section of the sinuses predominated (83.78%). The MS had the shape of the letter ‘C’ in 22.29% of the cases (C-shaped in 11.82% and inverted ‘C’ in 10.47%). The rarest was the MS resembling letter ‘S’, which only appeared in 11.48% of the patients (S-shaped in 5.74% and inverted ‘S’ in 5.74%). Only 16.22% of the patients had the MS that shifted neither its course nor its shape. ConclusionsThe MS might be an intraoperative marker of the midline, providing surgeons with good spatial orientation. Notwithstanding, the MS changed its course in the majority of the studied here patients, hence more careful transsphenoidal approach is needed to avoid iatrogenic neurovascular injuries.
Highlights
The transnasal transsphenoidal approach was first introduced as the preferred means for surgical access to the sella turcica and its close surroundings by Cushing [1] and Hirsch [2] at the beginning of the 20th century
The study was conducted as a retrospective analysis of 296 computed tomography (CT) of Polish patients (147 females, 149 males) who were referred to the Department of Medical Imaging of the University Hospital in Kraków, Poland
A statistically significant difference was found between the females and males in the average height of the main septum (MS) (p = 0.001, tStudent test for the independent variables)
Summary
The transnasal transsphenoidal approach was first introduced as the preferred means for surgical access to the sella turcica and its close surroundings by Cushing [1] and Hirsch [2] at the beginning of the 20th century. It has become an advantageous technique, used during surgical interventions undertaken for most intrasellar and parasellar neoplasms procedures [3]. Notwithstanding, the MS changed its course in the majority of the studied here patients, more careful transsphenoidal approach is needed to avoid iatrogenic neurovascular injuries
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