The dimensions of the sphenoid sinuses: evaluation before the functional endoscopic sinus surgery
Abstract
Background: The following study aimed to evaluate the dimensions (anteroposterior, transverse and vertical) of the sphenoid sinuses in the adult population. Materials and methods: The study was conducted as a retrospective analysis of the computed tomography (CT) scans of the paranasal sinuses of 296 patients (147 females and 149 males), who did not present any pathology in the sphenoid sinuses. The CT scans of the paranasal sinuses were done with the spiral CT scanner, without using any contrast medium. After obtaining transverse planes, frontal and sagittal planes were created using secondary reconstruction tool. Results: The anteroposterior dimension was found to be 2.65 cm on average, in the range of 0.5–4.3 cm. The transverse dimension was on average 1.98 cm, ranging from 0.5 cm to 4.9 cm. The average vertical dimension was found to be 2.1 cm, in the range of 0.7–3.7 cm. Conclusions: Due to the high incidence of the anatomical variants of the paranasal sinuses, a CT scan is recommended in all patients before a planned surgery in order to avoid the potential iatrogenic complications. Dimensions of the sphenoid sinuses might point towards more at risk variants, but there is still a substantial amount of research that needs to be done in that aspect.
Keywords: sphenoid sinusanatomydimensionsfunctional endoscopic sinus surgery
References
- Abdullah BJ, Arasaratnam A, Kumar G, et al. The sphenoid sinuses: computed tomographic assessment of septation, relationship to the internal carotid arteries and sidewall thickness in the Malaysian population. J HK Coll Radiol. 2001; 4: 185–188.
- Awadalla AM, Hussein Y, ElKammash TH. Anatomical and radiological parameters of the sphenoidal sinus among Egyptians and its impact on sellar region surgery. Egyptian J Neurosurgery. 2015; 30(1): 1–12.
- Becker DG. The minimally invasive, endoscopic approach to sinus surgery. J Long Term Eff Med Implants. 2003; 13(3): 207–221.
- Bogusławska R. Badanie zatok przynosowych metodą tomografii komputerowej dla celów chirurgii endoskopowej. Warszawa, 1995 .
- Elwany S, Yacout YM, Talaat M, et al. Surgical anatomy of the sphenoid sinus. J Laryngol Otol. 1983; 97(3): 227–241.
- Eryilmaz A, Ozeri C, Bayiz U, et al. Functional endoscopic sinus surgery (FESS). Turk J Med Res. 1993; 11(5): 221–223.
- Güldner C, Pistorius SM, Diogo I, et al. Analysis of pneumatization and neurovascular structures of the sphenoid sinus using cone-beam tomography (CBT). Acta Radiol. 2012; 53(2): 214–219.
- Haetinger RG, Navarro JAC, Liberti EA. Basilar expansion of the human sphenoidal sinus: an integrated anatomical and computerized tomography study. Eur Radiol. 2006; 16(9): 2092–2099.
- Jaworek-Troć J, Zarzecki M, Bonczar A, et al. Sphenoid bone and its sinus — anatomo-clinical review of the literature including application to FESS. Folia Med Cracov. 2019; 59(2): 45–59.
- Jaworek-Troć J, Zarzecki M, Mróz I, et al. The total number of septa and antra in the sphenoid sinuses - evaluation before the FESS. Folia Med Cracov. 2018; 58(3): 67–81.
- Kantarci M, Karasen RM, Alper F, et al. Remarkable anatomic variations in paranasal sinus region and their clinical importance. Eur J Radiol. 2004; 50(3): 296–302.
- Kapakin S. The paranasal sinuses: three-dimensional reconstruction, photo-realistic imaging, and virtual endoscopy. Folia Morphol. 2016; 75(3): 326–333.
- Kazkayasi M, Karadeniz Y, Arikan OK. Anatomic variations of the sphenoid sinus on computed tomography. Rhinology. 2005; 43(2): 109–114.
- Keast A, Yelavich S, Dawes P, et al. Anatomical variations of the paranasal sinuses in Polynesian and New Zealand European computerized tomography scans. Otolaryngol Head Neck Surg. 2008; 139(2): 216–221.
- Krzeski A, Osuch-Wójcikiewicz E, Szwedowicz P, et al. Chirurgia endoskopowa w leczeniu guzów jam nosa i zatok przynosowych. Mag ORL. 2004; 3(3): 79–84.
- Lupascu M, Comsa G, Zainea V. Anatomical variations of the sphenoid sinus: a study of 200 cases. ARS Medica Tomitana. 2014; 20(2): 57–62.
- Mafee MF, Chow JM, Meyers R. Functional endoscopic sinus surgery: anatomy, CT screening, indications, and complications. Am J Roentgenol. 1993; 160(4): 735–744.
- Mutlu C, Unlu HH, Goktan C, et al. Radiologic anatomy of the sphenoid sinus for intranasal surgery. Rhinology. 2001; 39(3): 128–132.
- Pérez-Piñas I, Sabaté J, Carmona A, et al. Anatomical variations in the human paranasal sinus region studied by CT. J Anat. 2000; 197 ( Pt 2): 221–227.
- Sareen D, Agarwal AK, Kaul JM, et al. Study of sphenoid sinus anatomy in relation to endoscopic surgery. Int J Morphol. 2005; 23(3).
- Štoković N, Trkulja V, Dumić-Čule I, et al. Sphenoid sinus types, dimensions and relationship with surrounding structures. Ann Anat. 2016; 203: 69–76.
- Terra ER, Guedes FR, Manzi FR, et al. Pneumatization of the sphenoid sinus. Dentomaxillofac Radiol. 2006; 35(1): 47–49.