Aim To define direct anatomical relations of the sphenoidal (alae minores), ethmoidal sinuses and optic nerve, with an emphasis on determining the effect of age on pneumatisation and dehiscence. Methods This retrospective, descriptive study involved 60 consecutive patients: 30 patients younger than 30 and30 patients older than 60 years of age. All patients underwent computerized tomography (CT). The relationship of the optic nerve and the sphenoidal and ethmoidal sinuses was classified. The presence of dehiscence in the bone structures, forming the optic canal, was checked. Dehiscence was defined as absence of visible bone density located between the sinus and the optic nerve. Protrusion of the optic nerve into the sphenoidal sinus was defined as optic nerve surrounded by pneumatised space. Results The most common type of relation between the optic nerve and sphenoidal sinus was type I, where the optic nerve was immediately adjacent to the lateral or superior wall of the sphenoidal sinus, without impression on the sinus wall. Dehiscence was documented in 15 (25%) cases, it was more common in older patients (8, 27%) than in younger ones (7, 23%). The pneumatisation processes were more frequent in patients over 60 (5, 17%) than in those younger than 30 years (4, 13%). Conclusion Surgeons and ophthalmologists should be aware of high frequency of dehiscence of sphenoidal sinus walls when treating adult patients in our population, especially when evaluating risks and complications of surgical procedures or when diagnosing inflammatory or tumorous processes in the close vicinity of posterior paranasal sinuses.
Moeller C, Welch K. Prevention and management of complications in sphenoidotomy. Otolaryngol Clin North Am. 2010;839–54.
2.
Badia L, Lund V, Wei W, Ho W. Ethnic variation in sinonasal anatomy on CT-scanning. Rhinology. 2005;210–4.
3.
Perez-Pinas I, Sabate J, Carmona A, Herrera C, Jimenez-Castellanos C, J. Anatomical variations in the human paranasal sinus region studies by CT. J Anatomy. 2000;221–7.
4.
Heskova G, Mellova Y, Holomanova A, Vybohova D, Kunertova L, Marcekova M, et al. Assessment of the relation of the optic nerve to the posterior ethmoid and sphenoid sinuses by computed tomography. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2009;149–52.
5.
Mamatha H, Saraswathi G, Prasanna L. Variations of sphenoid sinus and their impact on related neurovascular structures. Indmedica. 2010;121–4.
6.
Kazkayasi M, Karadeniz Y, Arikan O. Anatomic variations of the sphenoid sinus on computed tomography. Rhinology. 2005;109–14.
7.
Sapci T, Derin E, Almac S, Cumalı R, Saydam C, Karavus M. The relationship between the sphenoid and the posterior ethmoid sinuses and the optic nerves in Turkish patients. Rhinology. 2004;30–4.
8.
Abuzayed B, Tanriover N, Biceroglu H, Yuksel O, Tanriover O, Albayram S, et al. Pneumatization degree of the anterior clinoid process: a new classification. Neurosurg Rev. 2010;367–73.
9.
Hewaidi G, Omami G. Anatomic variation of sphenoid sinus and related structures in Libyan population: CT scan study. Libyan J Med. 2008;128–33.
10.
Tomovic S, Esmaeili A, Chan N, Shukla P, Choudhry O, Liu J, et al. High-resolution computed tomography analysis of variations of the sphenoid sinus. J Neurol Surg B Skull Base. 2013;82–90.
11.
Kikuchi R, Toda M, Tomita T, Ogawa K, Yoshida K. Analysis of sphenoid sinus lateral pneumatization for endonasal endoscopic surgery. Surg Neurol Int. 2015;166.
12.
Dasar U, Gokce E. Evaluation of variations in sinonasal region with computed tomography. World J Radiol. 2016;98–108.
13.
Yonetsu K, Watanabe M, Nakamura T. Age-related expansion and reduction in aeration of the sphenoid sinus: volume assessment by helical CT scanning. AJNR Am J Neuroradiol. 2000;179–82.
14.
Anderhuber W, Weiglein A, Wolf G. Cavitas nasi und Sinus paranasales in Neugeborenen-und Kindesalter. Acta Anat (Basel). 1992;120–6.
15.
Al-Abri R, Bhargava D, Al-Bassam W, Al-Badaai Y, Sawhney S. Clinically significant anatomical variants of the paranasal sinuses. Oman Med J. 2014;110–3.
16.
Dessi P, Moulin G, Castro F, Chagnaud C, Cannoni M. Protrusion of the optic nerve into the ethmoid and sphenoid sinus: prospective study of 150 CT studies. Neuroradiology. 1994;515–6.
17.
Al-Mujaini A, Wali U, Alkhabori M. Functional endoscopic sinus surgery: indications and complications in the ophthalmic field. Oman Med J. 2009;70–80.
18.
Delano M, Fun F, Zinreich S. Relationship of the optic nerve to the posterior paranasal sinuses: a CT anatomic study. AJNR Am J Neuroradiol. 1996;669–75.
19.
Bayram M, Sirikci A, Bayazit Y. Important anatomic variations of the sinonasal anatomy in light of endoscopic surgery: a pictorial review. Eur Radiol. 2001;1991–7.
20.
Renn W, Rhoton A. Microsurgical anatomy of the sellar region. J Neurosurg. 1975;288–98.
21.
Postma G, Chole R, Nemzek W. Reversible blindness secondary to acute sphenoid sinusitis. Otolaryngol Head Neck Surg. 1995;742–6.
22.
Sato H, Tsukuda M, Mochimatsu I, Furukawa M, Sawaki S. Sinusitis associated with disorders of visual acuity. ORL J Othorhinolaryngol Relat Spec. 1994;302–4.
23.
Patt B, Manning S. Blindness resulting from orbital complications of sinusitis. Otolaryngol Head Neck Surg. 1991;789–90.
24.
Shimo-Oku M, Miyazaki S, Shiraki K, Sugimoto T, Sotani H. Optic nerve involvement in posterior paranasal sinus diseases. Neuro-Ophthalmology. 1989;147–55.
25.
Simpson D, Moser L. Compressive optic neuropathy secondary to chronic sinusitis. Am J Optom Physiol Opt. 1988;757–62.
26.
Slavin M, Glaser J. Acute severe irreversible visual loss with sphenoethmoiditis “posterior” orbital cellulitis. Arch Ophthalmol. 1987;345–8.
27.
Rothstein J, Maisel R, Berlinger N, Wirtschafter J. Relationship of optic neuritis to disease of the paranasal sinuses. Laryngoscope. 1984;1501–8.
28.
Chandler J, Langenbrunner D, Stevens E. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 1970;1414–28.
29.
El Kammash T, Enaba M, Awadalla A. Variability in sphenoid sinus pneumatization and its impact upon reduction and complications following sellar region surgeries. The Egyptian Journal of Radiology and Nuclear Medicine. 2014;705–14.
30.
Stankiewicz J, Lal D, Connor M, Welch K. Complications in endoscopic sinus surgery for chronic rhinosinusitis: a 25-year experience. Laryngoscope. 2011;2684–701.
31.
Chastain J, Sindwani R. Anatomy of the orbit, lacrimal apparatus, and lateral nasal wall. Otolaryngol Clin North Am. 2006;855–64.
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