Anatomographic Variants of Sphenoid Sinus in Ethiopian Population.

Tizita K Degaga,Amenu T Wirtu,Seife T Dellie,Abay M Zenebe,Jickssa M Gemechu,Tequam D Woldehawariat

doi:10.3390/diagnostics10110970

Tizita K Degaga, Amenu T Wirtu + Show 4 more

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https://doi.org/10.3390/diagnostics10110970

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Abstract

Neurosurgeons often neglect the sphenoid sinus due to its deep location and difficulties in accessing during surgical interventions. Disease of the sphenoid sinus is difficult to diagnose since its presenting symptoms are difficult to recognize. Moreover, compared with other paranasal sinuses, the sphenoid sinus is considered the most variable air sinus in terms of its degree of pneumatization, number and position of inter-sinus septa, and its relationship with the surrounding anatomical structures. Anatomical variations of the sphenoid sinus are significant from a neurosurgical point of view. Understanding of these variations and its relationships with surrounding structures such as the internal carotid artery, optic nerve, and pituitary gland are clinically relevant to minimize injuries associated with surgical procedures that involve sphenoid sinus. We implemented principles of imaging using computed tomography to elucidate any anatomical variations of the sphenoid sinus in the Ethiopian population. We conducted a prospective study in 200 patients with ages 18–79, who underwent scans of the sphenoid sinus at the Tikur Anbessa Referral Teaching Hospital in 2017–2018. Our findings revealed an incidence of anatomographical variations in terms of pneumatization that varied between 2–50%. These variants include 2% conchal, 25.5% presellar, 50% sellar, and 22.5% postsellar pneumatization. We also demonstrated anatomographic variants in terms of septation, 77.5% single complete septa, 11.5% single incomplete, 10% double septa, and 1% absence of septa. In summary, the sellar pneumatization was found to be the most clinically relevant anatomographic variant among Ethiopians participating in the study, of which 90% were tomographically single septated. These variants must be taken into consideration during trans-sphenoidal surgery and knowledge of the variations has clinical implication in minimizing injuries during invasive surgical procedures involving the sphenoid sinus.

Highlights

The sphenoid sinus is the most inaccessible paranasal sinus, enclosed within the body of the sphenoid bone and intimately related to numerous neurovascular and glandular structures [1].The failure of surgeons to understand the racial variations of the anatomical landmarks of the sphenoid sinus is often described as a potential risk factor in clinical interventions [2]
Our findings showed that anatomographic variants of sphenoid sinus were 100 (50%) seller, 51 (25.5%)
We found that pneumatization of the anterior clinoid process (ACP) was 36 (18%), pterygoid plates (PP) was 3 (15%), and the greater wing of sphenoid was (GWS) 33 (16.5%) (Figure 3)

Summary

Introduction

The sphenoid sinus is the most inaccessible paranasal sinus, enclosed within the body of the sphenoid bone and intimately related to numerous neurovascular and glandular structures [1].The failure of surgeons to understand the racial variations of the anatomical landmarks of the sphenoid sinus is often described as a potential risk factor in clinical interventions [2]. Computerized tomography (CT) is an imaging modality used for diagnosing diseases and evaluating injuries It plays an important role in the diagnosis of anatomical variations, which has relevant implications in clinical decision making during surgical interventions. The sphenoid sinus received clinical significance after neurosurgeons discovered the trans-sphenoid approach for pituitary tumor surgeries in the new era of minimal invasive surgery [5] These mucous membrane lined air cells are situated within the body of the sphenoid bone, communicating with the roof of the nasal cavity through an opening into the sphenoethmoidal recess. It is closely related with the surrounding vital structures such as optic chiasm, cavernous sinus, pituitary gland, and internal carotid arteries [2,6]

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