Neurovascular Variations of Sphenoid Sinus: Impact on Transsphenoidal Surgery
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 4
Abstract
Aim: The aim of the study was to analyze the variations of neurovascular structures located in the sphenoid sinus in the form of optic canal (OC), vidian canal (VC), and foramen rotundum (FR), and carotid canal (CC) protrusion. The location of FR and VC from midline in relation to the lateral recess pneumatization (LRP). Materials and Methods: Computed tomography images, 1mm thin axial sections for 100 patients (50 male and 50 female) over the age of 18 years, obtained for any reason at our hospital were evaluated retrospectively with coronal and sagittal reconstructions. Patients with craniofacial trauma and any pathology (sinonasal malignancy, rhinosinusitis, and nasal polyps) distorting the normal anatomy were excluded. The type of sphenoid sinus in the axial, coronal and sagittal sections, the variations in the form of protrusions, and location from midline as a function of the LRP was analyzed. Results: The sellar (98%) and greater wing (31%) types were common in sagittal and coronal types. The LRP was not impacted by age. The FR was laterally placed on the left side (P < 0.001) when compared with the right. Bilaterally, the mean distance of FR from midline was compared, and the patients with LRP had significantly laterally placed FR (Left and Right - P < 0.001). This difference was not present in the VC location (Left-value = 0.205, right P = 0.266).The protrusion of the OC was associated with the anterior clinoid process (ACP) pneumatization, FR and VC protrusion with LRP was significantly associated (P < 0.001). OC and CC dehiscence was 16% and 3%. Conclusion: The LRP displaces the FR laterally than the VC. The protrusion of the VC, FR is significantly associated with the LR pneumatization as such as OC and ACP. Thus, the pre-operative analysis of the neurovascular structural variations would bring down the complication rates and help plan for the extended approaches.
Authors and Affiliations
Samiappan Sathish Prabu, R Veerapandian, S Pradeep, Mahalakshmi Rajendran
Keywords
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