Objective: This study aimed to describe anatomic variants of sphenoidal sinuses and adjacent structures. Methods: A retrospective and descriptive study was carried out at The National and University Teaching Hospital Hubert Koutoukou Maga (CNHU-HKM), of Cotonou in Benin from November 1st to December 31st. A review of CT scans skull was done for the subjects aged at least 16 years old. Anatomic variants of the sphenoid sinuses and adjacent structures have been investigated. Results: 225 CT scans of skull were analyzed. The sellar type was the most common type of pneumatization of sphenoid sinuses (74.7%). Pneumatization of anterior clinoid processes of greater and lesser wings of the sphenoid and of pterygoid processes was observed in 7.1%; 4.6%; 3.3% and 7.3%; respectively. Protrusion of carotid canals and optic canals, maxillary and vidian nerves were observed in 48.3%; 13.1%; 18% and 9.5%; respectively. Conclusion: Risky anatomic variants of the sphenoid sinuses and adjacent structures are also described by CT-scan among Beninese. Before any surgery and to avoid bad outcome, a precise approach of these risky anatomic variants must be carried out by using CT-scan.
Goal: The aim of this work is to study the relationship between the pneumatization of the adjacent structures of sphenoid sinuses and the protrusion of the neurovascular structures in the sinuses. Methods: A review of 225 CT scans skull was done for subjects aged at least 16 years old from November 1st to December 31st 2017. The pneumatization of adjacent structures of sphenoid sinuses and its relation with the protrusion of neurovascular structures surround the sinuses have been investigated. We used Fischer Exact test for comparison. The p value < 0.05 was expressed as significant. Results: Statistically significant associations were found between anterior clinoid process bilateral pneumatization and bilateral protrusion of carotid canal (p < 0.05) and of optic canal (p < 0.001). There were also, statistically significant correlations between bilateral pterygoid process pneumatization and bilateral protrusion of carotid canal and of optic canal (p < 0.001); and between pterygoid process bilateral pneumatization and bilateral protrusion of maxillary and vidian nerves (p < 0.001). An association was also found between bilateral pneumatization of great wings and bilateral protrusion of maxillary nerves (p < 0.001) and of vidian nerves (p < 0.05). Conclusion: Compared to the literature, the prevalence of pneumatization of the adjacent structures of sphenoid sinuses was lower on Beninese than Caucasian and Asian. But there were the same correlations with the protrusion of neurovascular structures. In case of endonasal surgery of the sphenoid sinuses, surgeon should be aware of How to cite this paper:
Background: Sub-Saharan Africa is the region most affected by the Human Immunodeficiency Virus (HIV) with an increasing prevalence of related cognitive impairments. Magnetic Resonance Imaging (MRI) plays an important role in the early detection of lesions. This work aimed to describe the MRI aspects of different brain lesions occurred in HIV positive patients in our practice. Methods: This was a descriptive cross-sectional study that took place from June 2014 to July 2016 in the medical imaging department of the EL RAPHA private Polyclinic in Libreville, Gabon. It included all patients referred for imaging for the exploration of a Central Nervous System (CNS) lesions at MRI, based on clinical and/or paraclinical arguments. Results: Among the 39 patients included, 19 (48.7%) had a previous brain CT scan, 11 of which were normal (28.2%). Thirty-five (89.74%) patients had a pathological MRI. The main etiologies found were toxoplasmosis (37.14%), tuberculosis (17.14%), cerebral atrophy (17.14%) and HIV encephalitis (14.28%). Among the eleven patients with a normal Computer Tomography scan, the MRI found 7 abnormalities including 1 case of toxoplasmosis, 3 cases of HIV encephalitis and 3 cases of Progressive Multifocal Leukoencephalopathy (PML). Conclusion: MRI played an important role in the diagnosis of CNS disorders in HIV-infected individuals. It can be used to differentiate and characterize various brain lesions. Improving its accessibility in sub-Saharan Africa should contribute to better care for people living with HIV.
The choledochal cyst is a rare congenital malformation of the bile ducts. It is considered as a precancerous state. The incidence of cancer in choledochal cyst increases with age and occurs around 32 years old. Therefore, young adults are often involved. In adults, clinical signs are rare and unspecific. We are reporting here the case of a cholangiocarcinoma in choledochal cyst in young adult diagnosed by ultrasonography, CT scan, and MRI and confirmed by histopathological examination.
Goal: This study aims to evaluate the contribution of the whole body scanner in the management of severe traumas. Patient and Method: It is a retrospective analytical study, carried out at the Armentieres Hospital Centre (France) over a period of 14 months. It analyzes computed tomography reports and emergency department results of severe trauma patients immediately stabled at the entrance or stabilized after benefiting from a full body scanner according to Vittel criteria. Results: One hundred eighty patients were included in the study with an average age of 32.71 years old. One hundred and twelve patients (62.2%) had at least one clinical sign and only 48 patients presented a lesion on the computed tomography (26.7%). Sixty-two patients (34.4%) showed neither clinical signs nor damage in scan. The radio-clinical correlation was bad at spinal and abdominal level, mediocre at brain and chest level, but it was medium in the pelvis. The average radiation dose per patient was 3319.21 mGy·cm. Conclusion: The whole body computed tomography or scanning allows fast images acquisition compatible with emergency situation and with a satisfactory diagnostic reliability, but still remains an irradiating exam. The results of this study lead to reflect on the use of Vittel criteria that could be improved to reduce the number of normal tests carried out.
Sphenoid sinuses are carved into the body of the sphenoid bone. They are probably the most variably pneumatized structures of the skull. They begin their pneumatization at the age of three and finished at adolescence. Several anatomic variants of sphenoid sinuses have been described in the literature. The agenesis of sphenoid sinuses in adults is very rarely found. We report two incidental cases of sphenoid sinuses agenesis discovered on CT scan in Benin, West Africa.
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