Abstract

(1) Background: The optic strut (OS) is a critical landmark for clinoid and paraclinoid surgical interventions. To our knowledge, the current literature only mentioned the OS as a possibility for a lesser sphenoidal wing (LSW) pneumatization path, without a proper study of the pneumatization patterns and prevalence within this structure. Thus, our aim was to fill in the missing information. (2) Methods: A retrospective study on 80 cone beam computed tomography (CBCT) files was conducted to assess the prevalence and the origins of pneumatization within the OS. (3) Results: The pneumatization patterns of the OS were: 56.25% from the sphenoid sinus, 1.25% from the posterior ethmoid air cells (PEAC), and 10% from Onodi cells (ONC). Simultaneous pneumatization of unique origin within the lesser sphenoidal wing (LSW) was found in 26.25% from the sphenoid sinus, 1.25% from PEAC, and 5% from ONC. Communication between both LSW roots through pneumatization was found in 6.25% of the files. (4) Conclusions: A careful radiological examination should precede clinical diagnosis and surgical interventions in the paraclinoid area to evaluate postoperative surgical risks and possible diffusion patterns for infection. Additionally, pneumatization within the OS alters its morphological features and thus, its utility as a landmark.

Highlights

  • IntroductionCares and Bakay stated that “no other portion of the optic canal is as important in characterizing an optic lesion as the strut” [3]

  • The cone beam computed tomography (CBCT) files were further exported as DICOM files, which were analyzed with the Planmeca Romexis Viewer 3.5.0.R software (Planmeca, Helsinki, Finland) [7]

  • Sound knowledge of sphenoidal and ethmoidal pneumatization possibilities could Sound knowledge of sphenoidal ethmoidal pneumatization possibilities could reduce the rate of complications during and different surgical procedures regarding the ante‐

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Summary

Introduction

Cares and Bakay stated that “no other portion of the optic canal is as important in characterizing an optic lesion as the strut” [3]. Signs such as OS erosion and enlargement of the SOF are “pathognomonic for an infraclinoid aneurysm”; deformation of the OS or concentric enlargement of the OC can be associated with optic tract tumors; and erosion of OS in association with other canal walls may suggest a nonvascular issue such as mucocele or tuberculosis of the sphenoid, orbital or nasopharyngeal malignancies or pituitary gland tumors [3]. Deformities of the OS have been encountered in carotid-cavernous fistulas, suprasellar cholestheatomas, and syndromes such as Down and Edwards [1]

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