open access

Vol 80, No 3 (2021)
Original article
Submitted: 2020-05-31
Accepted: 2020-07-20
Published online: 2020-08-07
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Protrusion of the carotid canal into the sphenoid sinuses: evaluation before endonasal endoscopic sinus surgery

J. Jaworek-Troć12, J. A. Walocha1, R. Chrzan2, P. Żmuda3, J. J. Zarzecki4, A. Pękala1, P. Depukat1, E. Kucharska5, M. Lipski1, A. Curlej-Wądrzyk6, M. P. Zarzecki1
·
Pubmed: 32789847
·
Folia Morphol 2021;80(3):642-649.
Affiliations
  1. Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
  2. Department of Radiology, Jagiellonian University Medical College, Krakow, Poland
  3. University of Pavia, Italy
  4. Medical University of Silesia, Katowice, Poland
  5. Departament of Gerontology, Geriatrics and Social Work, Jesuit University Ignatianum, Krakow, Poland
  6. Department of Integrated Dentistry, Dental Institute, Jagiellonian University Medical College, Krakow, Poland

open access

Vol 80, No 3 (2021)
ORIGINAL ARTICLES
Submitted: 2020-05-31
Accepted: 2020-07-20
Published online: 2020-08-07

Abstract

Background: Many reports have previously indicated the vast number of anatomical variations of the sphenoid sinuses, e.g. presence of the recesses. Notwithstanding, there are a few crucial neurovascular structures directly neighbouring with the sinuses. The following research aimed to evaluate frequency prevalence of the carotid canal’s protrusion into the sphenoid sinuses in adult population.
Materials and methods: Computed tomography (CT) scans of the paranasal sinuses of 296 patients (147 females, 149 males) were analysed in this retrospective study. The patients did not present any pathology in the sinuses. Spiral CT scanner Siemens Somatom Sensation 16 was used in the standard procedure in the option Siemens CARE Dose 4D.
Results: Protrusion of the carotid canal was found in the majority of the patients — 55.74%, more frequently in males (65.1% of the patients) than in females (46.26% of the patients). The said variant — regardless of gender — was noted more often bilaterally (41.55% of the cases: 29.93% females, 53.02% males) than unilaterally (14.19% of the cases: 16.33% females, 12.08% males). In the unilateral type (regardless of gender), the protrusion was more common for the left sphenoid sinus — 10.81% of the patients (12.24% females, 9.4% males) than for the right — 3.38% of the patients (4.08% females, 2.68% males).
Conclusions: Complicated structure of the paranasal sinuses, derived from the high prevalence of their anatomical variations, may perplex routine surgical interventions. Henceforth, referral for a CT scan is imperative in order to abate the risks associated with an invasive procedure in the said region.

Abstract

Background: Many reports have previously indicated the vast number of anatomical variations of the sphenoid sinuses, e.g. presence of the recesses. Notwithstanding, there are a few crucial neurovascular structures directly neighbouring with the sinuses. The following research aimed to evaluate frequency prevalence of the carotid canal’s protrusion into the sphenoid sinuses in adult population.
Materials and methods: Computed tomography (CT) scans of the paranasal sinuses of 296 patients (147 females, 149 males) were analysed in this retrospective study. The patients did not present any pathology in the sinuses. Spiral CT scanner Siemens Somatom Sensation 16 was used in the standard procedure in the option Siemens CARE Dose 4D.
Results: Protrusion of the carotid canal was found in the majority of the patients — 55.74%, more frequently in males (65.1% of the patients) than in females (46.26% of the patients). The said variant — regardless of gender — was noted more often bilaterally (41.55% of the cases: 29.93% females, 53.02% males) than unilaterally (14.19% of the cases: 16.33% females, 12.08% males). In the unilateral type (regardless of gender), the protrusion was more common for the left sphenoid sinus — 10.81% of the patients (12.24% females, 9.4% males) than for the right — 3.38% of the patients (4.08% females, 2.68% males).
Conclusions: Complicated structure of the paranasal sinuses, derived from the high prevalence of their anatomical variations, may perplex routine surgical interventions. Henceforth, referral for a CT scan is imperative in order to abate the risks associated with an invasive procedure in the said region.

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Keywords

sphenoid sinus, carotid canal, anatomy, radiology, laryngology

About this article
Title

Protrusion of the carotid canal into the sphenoid sinuses: evaluation before endonasal endoscopic sinus surgery

Journal

Folia Morphologica

Issue

Vol 80, No 3 (2021)

Article type

Original article

Pages

642-649

Published online

2020-08-07

Page views

7024

Article views/downloads

1872

DOI

10.5603/FM.a2020.0086

Pubmed

32789847

Bibliographic record

Folia Morphol 2021;80(3):642-649.

Keywords

sphenoid sinus
carotid canal
anatomy
radiology
laryngology

Authors

J. Jaworek-Troć
J. A. Walocha
R. Chrzan
P. Żmuda
J. J. Zarzecki
A. Pękala
P. Depukat
E. Kucharska
M. Lipski
A. Curlej-Wądrzyk
M. P. Zarzecki

References (42)
  1. 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.
  2. Anusha B, Baharudin A, Philip R, et al. Anatomical variants of surgically important landmarks in the sphenoid sinus: a radiologic study in Southeast Asian patients. Surg Radiol Anat. 2015; 37(10): 1183–1190.
  3. Bademci G, Unal B. Surgical importance of neurovascular relationships of paranasal sinus region. Turkish Neurosurgery. 2005; 15(2): 93–96.
  4. Becker DG. The minimally invasive, endoscopic approach to sinus surgery. J Long Term Eff Med Implants. 2003; 13(3): 207–221.
  5. Bogusławska R. Badanie zatok przynosowych metoda tomografii komputerowej dla celów chirurgii endoskopowej. Warszawa 1995.
  6. Bouthillier A, van Loveren HR, Keller JT. Segments of the internal carotid artery: a new classification. Neurosurgery. 1996; 38(3): 425–32; discussion 432.
  7. Ciric I, Ragin A, Baumgartner C, et al. Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery. 1997; 40(2): 225–236.
  8. Cope VZ. The Internal Structure of the Sphenoidal Sinus. J Anat. 1917; 51(Pt 2): 127–136.
  9. Dusick JR, Esposito F, Malkasian D, et al. Avoidance of carotid artery injuries in transsphenoidal surgery with the Doppler probe and micro-hook blades. Neurosurgery. 2007; 60(4 Suppl 2): 322–328.
  10. Elwany S, Elsaeid I, Thabet H. Endoscopic anatomy of the sphenoid sinus. J Laryngol Otol. 1999; 113(2): 122–126.
  11. Eryilmaz A, Ozeri C, Bayiz U, et al. Functional endoscopic sinus surgery (FESS). Turk J Med Res. 1993; 11(5): 221–223.
  12. Gardner PA, Kassam AB, Snyderman CH, et al. Outcomes following endoscopic, expanded endonasal resection of suprasellar craniopharyngiomas: a case series. J Neurosurg. 2008; 109(1): 6–16.
  13. 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.
  14. Hewaidi GH, Omami Gm. Anatomic variation of sphenoid sinus and related structures in libyan population: CT scan study. Libyan J Med. 2008; 3(3): 128–133.
  15. Jaworek-Troć J, Iwanaga J, Chrzan R, et al. Anatomical variations of the main septum of the sphenoidal sinus and its importance during transsphenoidal approaches to the sella turcica. Trans Res Anat. 2020; 21: 100079.
  16. 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.
  17. Jaworek-Troć J, Zarzecki M, Zamojska I, et al. The dimensions of the sphenoid sinuses: evaluation before the functional endoscopic sinus surgery. Folia Morphol. 2021; 80(2): 275–282.
  18. Kajoak SA, Ayad CE. Najmeldeen M, Abdalla EA. Computerized tomography morphometric analysis of the sphenoid sinus and related structures in Sudanese population. Glo/ Adv Res J Med Med Sci. 2014; 3(7): 160–167.
  19. 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.
  20. Kapakin S. The paranasal sinuses: three-dimensional reconstruction, photo-realistic imaging, and virtual endoscopy. Folia Morphol. 2016; 75(3): 326–333.
  21. Kazkayasi M, Karadeniz Y, Arikan OK. Anatomic variations of the sphenoid sinus on computed tomography. Rhinology. 2005; 43(2): 109–114.
  22. 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.
  23. 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.
  24. Leong JL, Batra PS, Citardi MJ. Three-dimensional computed tomography angiography of the internal carotid artery for preoperative evaluation of sinonasal lesions and intraoperative surgical navigation. Laryngoscope. 2005; 115(9): 1618–1623.
  25. Li Y, Sun J, Zhu X, et al. Study of the relationship between sphenoid sinus volume and protrusions in the sphenoid sinus. Forensic Med Anat Res. 2014; 02(01): 2–7.
  26. 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.
  27. Mafee MF, Chow JM, Meyers R. Functional endoscopic sinus surgery: anatomy, CT screening, indications, and complications. Am J Roentgenol. 1993; 160(4): 735–744.
  28. Mamatha H, Saraswathi G, Prasanna LC. Variations of sphenoid sinus and their impact on related neurovascular structures. Curr Neurobiol. 2010; 1(2): 121–124.
  29. Mutlu C, Unlu HH, Goktan C, et al. Radiologic anatomy of the sphenoid sinus for intranasal surgery. Rhinology. 2001; 39(3): 128–132.
  30. Nitinavakarn B, Thanaviratananich S, Sangsilp N. Anatomical variation of the lateral nasal wall and paranasal sinuses: a CT study for endoscopic sinus surgery (ESS) in Thai patients. J Med Assoc Thai. 2005; 88(6): 763–768.
  31. Ozturan O, Yenigun A, Degirmenci N, et al. Co-existence of the Onodi cell with the variation of perisphenoidal structures. Eur Arch Otorhinolaryngol. 2013; 270(7): 2057–2063.
  32. Perez-Pinas I, Sabate J, Carmona A, et al. Anatomical variations in the human paranasal sinus region studied by CT. J Anat. 2000; 197(2): 221–227.
  33. Priyadarshini D, Latha PV, Ashvini K, et al. The anatomical variations in the neurovascular relations of the sphenoid sinus: an evaluation by coronal computed tomography. Turk Neurosurg. 2015; 25(2): 289–293.
  34. Sareen D, Agarwal AK, Kaul JM, et al. Study of Sphenoid Sinus Anatomy in Relation to Endoscopic Surgery. Int J Morphol. 2005; 23(3): 261–266.
  35. Sasagawa Y, Tachibana O, Doai M, et al. Carotid artery protrusion and dehiscence in patients with acromegaly. Pituitary. 2016; 19(5): 482–487.
  36. Sirikci A, Bayazit YA, Bayram M, et al. Variations of sphenoid and related structures. Eur Radiol. 2000; 10(5): 844–848.
  37. Standring S. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. Elsevier Ltd, Spain 2008: 830–845.
  38. Stecco A, Boccafoschi F, Falaschi Z, et al. Virtual dissection table in diagnosis and classification of Le Fort fractures: A retrospective study of feasibility. Trans Res Anat. 2020; 18: 100060.
  39. Tan HKK, Ong YK. Sphenoid sinus: an anatomic and endoscopic study in Asian cadavers. Clin Anat. 2007; 20(7): 745–750.
  40. Tan HM, Chong VF. of the paranasal sinuses: normal anatomy, variations and pathology. CME Radiology. 2001; 2(3): 120–125.
  41. Terra ER, Guedes FR, Manzi FR, et al. Pneumatization of the sphenoid sinus. Dentomaxillofac Radiol. 2006; 35(1): 47–49.
  42. Tomovic S, Esmaeili A, Chan NJ, et al. High-resolution computed tomography analysis of variations of the sphenoid sinus. J Neurol Surg B Skull Base. 2013; 74(2): 82–90.

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