Pneumatization Of Sphenoid Sinus Research Articles

Computed tomography based evaluation of the association between sphenoid sinus pneumatization patterns and variations of adjacent bony structures in relation to age and gender

Many studies revealed that the sphenoid sinus pneumatization (SSP) affects the protrusion/dehiscence of adjacent structures including optic canal (OC), foramen rotundum (FR), vidian canal (VC), and carotid canal (CC). Knowledge of this relationship bears vital importance to identify the safest surgical route during transsphenoidal procedures. Therefore, we aimed to determine the individualized prevalence of the protrusion/dehiscence of adjacent structures based on sagittal and coronal SSP (SSSP and CSSP) patterns. Computed tomography images of 300 patients were analysed to identify the SSSP and CSSP types, and the protrusion/dehiscence of adjacent structures was determined. The relationship between the variables was examined using statistical analysis in terms of age, gender, and laterality. The most prevalent SSSP type was postsellar (62.7%), followed by sellar (30%), presellar (6.6%), and conchal (0.7%). In 71.3% of patients, five types of CSSP were observed, with 23.6% and 21.7% exhibiting Type IV and V, respectively. Our results indicated that postsellar type, Type IV and V CSSP associated with the highest likelihood of protrusion/dehiscence of OC, FR, VC, and CC. Furthermore, no significant correlation was observed between these qualitative variables and gender, with the exception of the VC dehiscence, the protrusion of OC and CC. No notable differences were identified with respect to laterality. Also, the probability of having postsellar type, Type IV and V CSSP, as well as the protrusion of OC, VC, and CC, decreased with increasing age. Further detailed analysis of this association is required to predict the size of the surgical window and to prevent neurovascular injury.

Evaluation of Sphenoid Sinus Pneumatization Subtypes in Posteroanterior and Lateral Directions on CT Imaging

Background: Sphenoid sinus (SS) variations are diverse, and identifying them before transsphenoidal interventions is essential. The gold standard imaging method for assessing the morphological characteristics of the SS is computed tomography (CT), which yields valuable information. Objectives: This study used CT imaging to evaluate SS pneumatization in the Turkish population's posteroanterior (PA) and lateral directions. Methods: Head CT images of 509 cases in total were evaluated retrospectively. Initially, SS types were determined based on PA pneumatization. Afterward, the new classification was used, and SS pneumatizations were defined in the lateral direction accordingly. Results: According to PA pneumatization, conchal (0.6%), presellar (16.7%), sellar (66.4%), and post-sellar pneumatization (16.3%) were detected. Accordingly, the relationship between SS type and gender was insignificant (P = 0.354). When the lateral type pneumatization classification was used, the right lateral body (39.9%) and left lateral body (32.2%) were found to be the most common types. The relationship between SS lateral-type pneumatization and gender was insignificant (P = 0.388). Conclusions: Sphenoid sinus pneumatization shows significant individual variability, which is beneficial to evaluate before surgery. In addition, more information was obtained about pneumatization using lateral direction typing as a new classification.

Magnetic Resonance Imaging Features of the Sphenoid Sinus in Patients with Non-Functioning Pituitary Adenoma.

Background and Objectives: A magnetic resonance imaging (MRI) scan is part of the diagnostic protocol in pituitary adenoma patients. The goal of the present study is to present and analyse the MRI appearances of the sphenoid sinus (SS) in patients with non-functioning pituitary adenoma (NFPA). Materials and Methods: This is a retrospective case-control study conducted between January 2015 and December 2023 in a tertiary referral hospital. Forty NFPA patients were included in the study group, while the control group consisted of 30 age- and gender-matched cases. Results: The sellar type of SS pneumatization was the most frequently encountered pattern among both groups. The presence of the lateral recess of the SS, mucosal cysts, and sphenoethmoidal cells was similar in both patient groups. The proportion of patients with SS mucosal thickness greater than 3 mm was 42.5% in NFPA group and 3% in the control group, and this difference was statistically significant (p < 0.001). The space between the two optic nerves was significantly larger in the NFPA group as compared to the control group (p < 0.001). Conclusions: Our study was able to establish a statistically significant association between the presence of NFPA and both the thickening of the SS mucosa and increased space between optic nerves.

Do Anatomical Variations Affect the Location of Solitary Sphenoid Sinus Fungal Balls? A 10-Year Retrospective Study

Background and Objectives: Sinonasal fungal balls (FBs) most commonly occur in the maxillary sinus, followed by the sphenoid sinus (SS). Relatively little is known about the predisposing factors and pathogenesis of unilateral sphenoid sinus fungal balls (SSFBs) compared to maxillary sinus FBs. We investigated whether anatomical variations have clinical implications for the location of unilateral SSFBs.Methods: This study included 33 patients who underwent endoscopic sinus surgery for unilateral SSFBs between 2010 and 2021. Preoperative computed tomography scans were used to analyze the presence of anatomical variations, including sphenoid lateral recess, complete accessory septum of the SS, types of SS pneumatization, anterior and posterior nasal septal deviation (NSD), cephalocaudal NSD, concha bullosa (CB), Haller cell (HC), paradoxical middle turbinate (MT), everted uncinated process (UP), and Onodi cell.Results: The presence of HC (33.3% vs. 12.1%, p=0.04), complete accessory septum of the SS (51.6% vs. 25.8%, p=0.04), and the sellar type of the SS (90.9% vs. 50%, p=0.003) differed significantly according to the presence or absence of FBs in the SS. However, other anatomical variations, including NSD, CB, paradoxical MT, everted UP, Onodi cell, and sphenoid lateral recess, were not significantly associated with the presence of unilateral SSFBs (all p&gt;0.05). In the multivariable analysis, only sellar-type pneumatization of the SS showed a statistically significant relationship with SSFB, not the combined conchal and presellar type (adjusted odds ratio, 8.96; 95% confidence interval, 1.27–63.19; p=0.03).Conclusion: We demonstrated that unilateral SSFBs were most strongly associated with the ipsilateral type of SS pneumatization, followed by the presence of HC and a complete accessory septum of the SS. Intranasal anatomical variations may play a significant role in the location of unilateral SSFBs.

Multiple coexisting variations of skull and cervical spine anatomy in a symptomatic patient - uncommon or uncommonly noticed? A CT-based case study.

Among many anatomical variations of the skull and cervical spine, some may be an underlying cause of a disease, while others remain clinically silent. The estimated individual prevalences of them differ, but given the available data it is impossible to clarify how frequently they coexist with each other. The following study presents an example of seven anomalies, amongst which at least few have manifested clinically in the examined patient. A 35 y.o. Polish woman who suffered from chronic sinusitis was subjected to a computed tomography scan. Mild thickening of the anterior ethmoidal cells' mucosa, bilateral concha bullosa, paradoxical right middle turbinate, bilateral uncinate process pneumatization and arrested pneumatization of sphenoid sinus were found and addressed in context of the reported symptoms. Simultaneously other, clinically silent anatomical anomalies, were found - namely ossification of the anterior petroclinoid ligament, incomplete medial basal canal and bilateral arcuate foramen. To the best knowledge of the authors, this case report is the first to present such a coexistence of this many various anatomical anomalies, among which some played a crucial part in the chronic sinusitis experienced by the patient. Concurrence of multiple variations in the same anatomical area or functional unit may exacerbate clinical presentation of a patient. Identifying a single anomaly ought to warrant a thorough investigation into any other potentially existing variants.

A computed tomography (CT)-based morphometric study of various skull base parameters and their anatomical relationships relevant to endoscopic endonasal skull base surgery.

Endoscopic skull base surgery requires a thorough understanding of skull base anatomy. Orientation to regional anatomy to avoid complications like internal carotid artery injury can be assisted by knowledge of certain bony landmarks. These landmarks are themselves highly variable structures. This study focuses on the radiological morphometric characterization of these landmarks, which can be of great assistance to surgeons for better planning of endoscopic skull base approaches. Computed tomography scans of patients without skull base pathologies were analyzed retrospectively for the following parameters - Vidian canal (VC) length, VC and foramen rotundum (FR) distance from midline, the angle between the axis of VC and petrous internal carotid artery (pICA) and between VC and palatovaginal canal, the horizontal, vertical and direct distances between VC and FR and the patterns of sphenoid sinus (SS) pneumatization. The VC-pICA angle was more obtuse and VC and FR were placed farther off the midline on the left as compared to the right side. Similarly, the distances between VC and FR were more on the left side. The VC length and distance of VC and FR from the midline were longer in males than in females. The VC-pICA angle was more obtuse in females. The post-sellar variant was the predominant pneumatization pattern seen (57.9%), and the incidence of lateral recess pneumatization was 15%. The results of our study can be utilized for a better understanding of the anatomy of the skull base. In skull base pathologies with distorted anatomical landmarks, a basic understanding of their interrelations can be used to have a better anatomical orientation. All these measures can help in avoiding complications and make extended endoscopic approaches safe.

Is there a relationship between sphenoid sinus pneumatization and carotid canal–intersinus septa connection?

Objectives We investigated the relationship between sphenoid sinus (SS) pneumatization types, carotid canal types and carotid canal–intersinus septa connection. Methods The paranasal sinus computed tomography (PNSCT) images of 274 patients (141 males and 133 females) were evaluated retrospectively. SS pneumatization, SS intersinus septation, SS intersinus septa deviation, carotid canal classification, carotid canal dehiscence, carotid canal–intersinus septa connection and presence of Onodi cells were evaluated. Results In presellar and sellar SS, type 1 carotid canal was detected. However, type 3 carotid canal was detected more in postsellar SS. On the left side, in 26.4% of the postsellar SS, carotid canal dehiscence was detected. On the right side, carotid canal-intersinus septa connection was detected in 55.8% of the postsellar SS and 35.1% of the sellar SS. On the left side, it was detected 58.3% of the postsellar SS and 30.9% of the sellar SS. In postsellar type SS pneumatized cases, right caroid canal-intersinus septa connection increased by 5.4 fold and left carotid canal-intersinus septa connection increased by 7.3 fold compared to presellar type SS pneumatization. In 2≥ intersinus septa group, left carotid canal-intersinus septa connection increased 5.0 fold compared to ‘no septa’ group. Conclusion In this study, we evaluated SS pneumatization types and their relation with carotid canal types and carotid canal-intersinus septa connections. Type 3 carotid canal (protrudation to SS wall) was detected more in postsellar SS. In these cases, surgeons should be very careful during surgery to avoid damage to the internal carotid artery (ICA).

Frequency of Sphenoid Sinus Pneumatization in Panoramic Radiographs

Objective: Sphenoid sinus is an irregular cavity in the skull and sphenoid sinus pneumatization (SSP) is a variation of the sphenoid sinus that can observe on the radiographs when it reaches large sizes. It is aimed to evaluate the prevalence of SSP in panoramic radiographs in this study.&#x0D; Methods: Panoramic radiographs of 500 patients were performed in this study. The patients who applied to our department with miscellaneous dental complaints were over the age of 14. The gender and age of the patients were recorded and the right, left, or bilateral visibility of SSP was examined. The study subjects were classified into four age categories and SSP prevalence was evaluated with gender, age, and visibility by statistical analyses.&#x0D; Results: Female patients were more than males (78%, and 22% respectively). SSP was found in approximately one-third of the patients (33%) in the panoramic radiographs. Of these, 69 (41.8%) were on the right only, 40 (24.2%) on the left only, and 56 (33.9%) were bilateral. SSP was more common in women (24.2%) and was mostly detected in group 2 (14.4%). Any significant difference was not found in terms of right, left, and bilateral SSP, gender, and age groups. (p ›.05).&#x0D; Conclusion: SSP can be superposed in the zygomatic arch as a radiolucency that can be misdiagnosed as a cyst. SSP was observed in approximately one-third of patients in this study so dentists should be aware of superimposed surrounding structures of the maxillofacial region for accurate diagnosis.

Computed tomography-based assessment of sphenoid sinus and sella turcica pneumatization analysis: a retrospective study.

A preoperative three-dimensional examination of the sphenoid sinus anatomy, its pneumatization pattern, and its relevance to neighboring neurovascular constructions is crucial to preventing possible complications. In this study, the aim was to evaluate the relationship between sphenoid sinus pneumatization types and the sella turcica using computed tomography (CT). CT data from 420 patients referred to the Department of Dentomaxillofacial Radiology were evaluated retrospectively. Sella pneumatization types were classified as conchal, presellar, incomplete sellar, and complete sellar, and they were evaluated. Obtained data were evaluated using the IBM SPSS 25.0 (Armonk, New York, USA) package program. CT images of 420 individuals, including 174 women and 246 men with a mean age of 43.87 ± 17.58 years, were included in the study. When the sella turcica morphologies were evaluated, the most widespread morphological type was irregularity in the posterior part of the dorsum sella, in 51.2% of cases. In addition, a statistically significant correlation was found between the pneumatization of the sphenoid sinus and the morphological types of sella (p < 0.05). In this research endeavor, the predominant observation comprised the complete sellar sphenoid sinus pneumatization type, exhibiting irregularity in the posterior aspect of the dorsum sella, representing one of the sellar types. Notwithstanding, it is imperative to conduct additional investigations to establish the generalizability of the present study's findings.

Unravelling the Complex Relationship Between Frontal Sinus Pneumatization and Paranasal Sinus Anatomical Variants: Insights from CT Imaging.

The aim of this study was to analyse the relationship between frontal sinus pneumatization and its effect on various variations of paranasal sinuses on paranasal sinus CT scan. A total number of 100 patients (51 males, 49 females) were included in this study. Patients were divided into three groups on the basis of their frontal sinus pneumatization extent on paranasal sinus CT as Type 1 pneumatization (aplasia and hypoplasia), Type 2 pneumatization (medium) and Type 3 pneumatization (hyperplasia). The prevalence of various variations like pneumatization of upper and middle turbinate, presence of agger nasi, Haller and Onodi cell, maxillary sinus hypoplasia, extent of sphenoid sinus pneumatization, pneumatization of anterior clinoid process, pterygoid process and greater wing of sphenoid sinus, dehiscence and protrusion of internal carotid artery and optic nerve types were ascertained and compared within each group. The prevalence of Onodi cell, anterior clinoid process and greater wing of sphenoid pneumatization and optic nerves type 3 and 4 were higher in Type 3 frontal sinus pneumatization group as compared with other groups. Excessive pneumatization of frontal sinus has various effects on paranasal sinus variations. Surgeons dealing with endoscopic sinus surgery, maxillofacial and skull base surgery must be vigilant of association between these variations preoperatively for avoiding complications.

Evaluation of the relationship between sphenoid sinus morphology and area and volume by computed tomography.

The aim of this study is to investigate the effect of sphenoid sinus pneumatization types, Onodi cell (OC), internal carotid artery (ICA), optic nerve (ON) on sinus volume and area on computed tomography (CT) images. The CT images of 150 patients were evaluated. Sphenoid sinus pneumatization types, OC prevalence, protrusion and dehiscence of ICA and ON, the volume and area were evaluated. The sinus volume and area were statistically higher in patients with bilateral protrusion of ICA and ON then patients without protrusion of ICA and ON. The mean volume and area of sinus were 9949.4 ± 351.0mm3 and 4570.9 ± 1604.9mm2, respectively. The volume and area of sphenoid sinus did not differ significantly between groups with and without OC. The postsellar b type sphenoid sinus had the highest volume, while conchal type has the least volume. Bilateral protrusion and dehiscence of ICA and bilateral protrusion of ON caused a significant increase in the sphenoid sinus volume and area. The presence of ICA and ON, the pneumatization of the sinus is an anatomical structure that can affect the sinus volume and area. Before the operation, three-dimensional evaluation should be performed to determine whether these structures are bilateral/unilateral and it should be remembered that the sinus volume and area can change.

Endoscopic Endonasal Transtuberculum Approach for Pediatric Tuberoinfundibular Craniopharyngioma: 2-Dimensional Operative Video.

The endoscopic endonasal transtuberculum approach grants access to suprasellar and retrochiasmatic lesions with hypothalamic involvement. Here, we present a case of a 13-year-old boy with a history of stunted growth, decreased vision, headaches, and low energy with a tuberoinfundibular craniopharyngioma. The patient consented to the procedure. Evaluation of the sphenoid sinus pneumatization, internal carotid artery disposition, presence of clinoidal rings, variations of the infrachiasmatic corridor (optic chiasm location, height of dorsum sella), and location of the pituitary stalk are crucial for surgical strategy. Harvesting of nasoseptal flap and access to the sphenoid sinus; drilling the sella, tuberculum, and chiasmatic sulcus up to the limbus sphenoidalis and laterally exposing the clinoidal carotid artery segment; wide dural opening to the level of distal rings inferolaterally and falciform ligaments superolaterally; identification and coagulation of superior hypophyseal branches providing tumor supply; intracapsular dissection and debulking and subpial sharp dissection at the hypothalamic tumor interface to achieve complete removal; and reconstruction with inlay collagen, fascia lata, and nasoseptal flap. Preservation of the superior hypophyseal arteries and stalk is essential for preventing pituitary dysfunction. Preoperative reckoning of hypothalamic invasion and identification of adequate interface aids in avoiding complications. To reduce CSF leak risk, multilayer reconstruction was performed and lumbar drain placed postoperatively. For retroclival extension, intradural pituitary transposition should be considered to expand the corridor; in patients with preoperative hypopituitarism, pituitary sacrifice is most effective to increase retroclival access.

Prevalence of Anatomical Variations of Sphenoid Sinus and Its Adjacent Structures Pneumatization and Its Significance: A CT Scan Study.

The purpose of our study was to assess the prevalence of variations and type of sphenoid sinus and its adjacent structures pneumatization and its significance. This prospective study included 114 patients who underwent CT of the paranasal sinuses. The CT scan in axial, coronal and mid sagital section were analysed to assess the type of pneumatization of the sphenoid sinus and its adjacent structures like; anterior clinoid process, greater wing of sphenoid and pterygoid process. The sphenoid sinus pneumatization was classified into Conchal, Presellar, and Sellar types, later comprised of sellar and post-sellar types. Out of 114 cases of pneumatized sphenoid sinus, 5.2% cases were conchal type, 26.3% cases Presellar type and 68.4% cases sellar type. The one or more adjacent structures was pneumatized in 71 (62.2%) of cases. The adjacent structures which found to be pneumatized are anterior clinoid process in 26.3%, Pterygoid process in 23.6%, and greater wing of sphenoid in 12.3% cases. The pneumatization of adjacent structures was more prevalent in sellar type of sphenoid sinus, followed by pre-sellar type and no pneumatization in conchal type. The anterior clinoid process pneumatization was present in 26.1% of cases, in which 3 (2.6%) cases in pre-sellar type and 27 (23.5%) cases in sellar type. It was unilaterally pneumatized in 13 (11.4%) and bilaterally in (17 (14.9%) cases. The pterygoid process pneumatization was present in 27 (23.6%) of cases, unilateral in 16 (14%) cases and bilateral in 11 (9.6%) cases. The Greater wing of sphenoid pneumatization was found in 14 (12.3%) cases, no cases in conchal types, 2 (1.8%) in pre-sellar type, and 12 (10.4%) in sellar type There was no statistically difference found in between right and left side of sphenoid sinus and its structure pneumatization. The extent of pneumatization of the sphenoid sinus has clinical and surgical implications in sinus diseases, sellar and central skull base lesions.

Sphenoid Sinus Pneumatization Types and Correlation with Adjacent Neurovascular Structures Using Cone-Beam Computed Tomography.

The online version contains supplementary material available at 10.1007/s12070-023-03796-0.

Anatomical Variations of the Sphenoid Sinus and its Adjacent Critical Structures Using Cone Beam Computed Tomography: A Cross-Sectional Study

Background: The aim of the study was to determine the anatomical variations of the sphenoid sinus and its adjacent critical structures using Cone-Beam Computed Tomography (CBCT).&#x0D; Methods: This cross-sectional study was conducted on CBCT scans of 67 females and 84 males between 18 to 67 years. Presence/ absence of intersphenoid septa, sphenoid sinus pneumatization and its type (conchal, presellar, sellar, and postsellar a and b), protrusion of the optic canal and carotid canal into the sphenoid sinus, optic canal and carotid canal dehiscence, and Anterior Clinoid Process (ACP) pneumatization was evaluated on CBCT scans, and their prevalence and correlation were calculated. Data were analyzed by the Chi-square test (alpha=0.05).&#x0D; Results:The prevalence of intersphenoid septa was 98.68%. Postsellar type a was the most common type of sphenoid sinus pneumatization with a prevalence of 41.3%. The prevalence of conchal, presellar, sellar and postsellar b types was 0, 11, 30, and 17.7%, respectively. The prevalence of optic canal and carotid canal protrusion into the sphenoid sinus was 50 and 52.7%, respectively. The prevalence of optic canal and carotid canal dehiscence was 48.3 and 40.3%, respectively. The prevalence of ACP pneumatization was 45%. Optic canal and carotid canal protrusion had a significant correlation with ACP pneumatization (p&lt;0.001). Also, carotid canal and optic canal protrusion and dehiscence were significantly correlated with degree of sphenoid sinus pneumatization (p&lt;0.001).&#x0D; Conclusion: Sphenoid sinus pneumatization significantly increases the likelihood of carotid canal, optic canal protrusion into the sphenoid sinus and their dehiscence, therefore, a preoperative 3D imaging is strongly recommended prior to trans-sphenoidal surgical procedures.

A cone beam computed tomographic study on sphenoid sinus pneumatization

A cone beam computed tomographic study on sphenoid sinus pneumatization

Anatomical evaluation of sphenoid sinus, foramen rotundum, and vidian canal for ventrolateral skull base surgery: A radiological study

Introduction: We aimed to evaluate the pneumatization of the sphenoid sinus (SS) and configuration of the vidian canal (VC) and foramen rotundum (FR). Materials and Methods: This study was performed on a total of 259 coronal and sagittal computed tomography (CTs) scans that we divided into rhinosinusitis (RS), nasal septum deviation (NSD), nasal polyposis (NP), and control (C) groups. We performed various morphometric measurements on CTs and evaluated the SS pneumatization and the position and protrusion of the FR and VC. Results: The mean age was found to be 42.42 ± 1.28 and 44.06 ± 1.45 in 149 males and 110 females, respectively. Significant differences were found among all morphometric measurements in the right and left side measurements and between genders except for the distance between VC and FR on both sides. The rotundum angle and bilateral VC distance values were found to be high in the NP and NSD groups. There was a difference in the distribution of categorical data between patient groups. We found prevalence of the FR and VC Type I as 3.3% and 13.3%, Type II as 35.5% and 43.65%; Type III as 61.2% and 43.05%, respectively. The position of FR was medial in 45.15%, online in 35.95%, and lateral in 18.9% of cases and SS pneumatization with lateral recess in 41.6%, tangent in 16.7%, and less pneumatized in 41.7% of cases in total. Discussion and Conclusion: Our findings show that the configuration of the structures, which are important anatomical landmarks for ventrolateral skull base surgery, changes in patients with anatomical variations and inflammatory sinonasal diseases.

A Comprehensive Computed Tomographic Analysis of Pneumatization Pattern of Sphenoid Sinus and Their Association with Protrusion/Dehiscence of Vital Neurovascular Structure in a Pakistani Subgroup.

To determine the clinically significant association between pneumatization types of the sphenoid sinus (SS) and protrusion/ dehiscence of the optic nerve (ON) and the internal carotid artery (ICA). This prospective cross-sectional study was conducted between November 2020 and April 2021 at the Dow Institute of Radiology, Dow University of Health Sciences, Karachi. This study examined 300 computed tomography (CT) PNS patients aged 18-60 years. The forms of SS pneumatization, extent of pneumatization to the greater wing (GW), anterior clinoid process (ACP), and pterygoid process (PP), as well as the protrusion/dehiscence of the ON and ICA were examined. A statistical relationship was identified between pneumatization type and protrusion/dehiscence of the ON and ICA. The study included 171 men and 129 women with an average age of 39.28 ± 10.9 years. The most commonly encountered pneumatization type was postsellar (63.3%), followed by sellar (27.3%), presellar (8.7%), and conchal (0.75%). The most frequent extended pneumatization was observed up to PP (44%), followed by ACP (31.33%), and GW (16.67%). The rate of dehiscence of the ON and ICA was less than that of protrusion of the same structures. The association between postsellar and sellar pneumatization types and protrusion of the ON and ICA was statistically significant (p < 0.001), with the postsellar type showing more protrusions of the ON and ICA than the sellar type. The pneumatization type of SS has a significant impact on the protrusion/dehiscence of adjacent vital neurovascular structures and should be mentioned in CT reports to alert surgeons for any disastrous intraoperative complications and outcomes.

Factors affecting the location of sphenoid sinus ostium: a binary logistic regression analysis.

Sphenoid sinus is a type of sinus surrounded by critical structures so that its injury potential to induce complications during surgery. The purpose of this study was to investigate the factors affecting the location of the sphenoid sinus natural ostium (SSO) to provide valuable data for endoscopic sinus surgery. Ostiomeatal unit (OMU) computerized tomography (CT) was performed on 198 subjects. Across the left and right sides, 396 evaluation results were obtained. The vertical distance to determine the location of the SSO was analyzed based on Lines 1, 2 and 3 on the sagittal image. The horizontal distance was analyzed based on Lines 4 and 5 on the axial image. The upper, lower, medial and non-medial borders were defined according to the location of the SSO. The presellar, sellar and postsellar types were categorized according to the level of sphenoid sinus pneumatization (SSP) on the sagittal image. The presence and absence of Onodi cells were defined on the coronal image. Binary logistic regression analysis was performed to investigate each factor. As the rostrum width of the SSO on the horizontal position increased, the position toward non-medial boarder increased by 4.902 times so that the natural ostium showed a trend of lateralization. For the postsellar type, compared to the presellar type, the position toward the non-medial boarder decreased by 0.223 times, indicating that the postsellar type had the natural ostium showing a trend of medialization. In the presence of Onodi cells, the position toward the lower boarder increased by 2.599 times with a significant association. The results in this study indicated that the presellar type of SSP had the natural ostium exhibiting lateralization with an increase in the rostrum width, whereas the postsellar type had the natural ostium exhibiting medialization with a decrease in the rostrum width. Based on these findings, the methods to widen the natural ostium may be diversified.

Cone beam computed tomography evaluation of sphenoid sinus in different sagittal skeletal pattern.

The purpose of this study is to explore sphenoid sinus variations in individuals with various sagittal skeletal anomalies using cone-beam computed tomography (CBCT). We retrospectively analyzed sphenoid sinus pneumatization on CBCT images of 126 patients aged 18-86 years. The anteroposterior skeletal relationships of the maxilla and mandible were classified as skeletal class I, II or III using the A point-nasion-B point (ANB) angle measured in the sagittal plane. The extensions of the sphenoid sinus were evaluated on three planes including axial, sagittal and coronal sections. The study population consisted of 84 females (66.7%) and 42 males (33.3%), including 52 (41.3%) class I, 38 (30.1%) class II, and 36 (28.6%) class III cases. The conchal type of sphenoid sinus was not encountered. Presellar sinuses were detected in only 3 (5.8%) class I cases. Incomplete sinuses were detected in 16 (30.8%) class I, 7 (18.4%) class II, and 15 (41.7%) class III cases. Complete sinuses were detected in 33 (63.4%) class I, 31 (81.6%) class II, and 21 (58.3%) class III cases. Lateral extensions were found in 103 (40.9%) of the 252 sinus walls: 33 (31.7%) in class I, 45 (59.2%) in class II, and 25 (34.7%) in class III sinuses. Regional sphenoid sinus anatomy can be carefully examined via CBCT. The sphenoid sinus pneumatization did not differ significantly in patients exhibiting different types of sagittal skeletal closure, with the exception of the lesser wing type.