OBJECTIVE: To clarify the three-dimensional anatomical features of the sphenoid sinus and its surrounding structures as are relevant to performing an endoscopic sphenoidotomy. METHODS: Various dimensions of 224 CT images of the sphenoid sinus and surrounding structures from 122 Japanese adult patients were measured using the multiplanar reconstruction technique. RESULTS: The mean distance from the nasal sill to the sphenoid ostium was nearly 66 mm, and that from the sphenoid ostium to the posterior wall of the sphenoid sinus was nearly 14 mm. The angles from the sphenoid ostium to both the carotid artery and the optic canal varied among the patients. The sphenoid ostium was located at almost the vertical midpoint of the anterior wall of the sphenoid sinus. CONCLUSION: The present study provides anatomical information about the sphenoid sinus and surrounding structures that is essential for avoiding complications in performing an endoscopic sphenoidotomy.
Granulomatosis with polyangiitis (GPA) sometimes involves the eye orbit; however, choroidal involvements in GPA had been rarely reported. We report a rare case presenting with a choroidal mass in an 83-year-old Japanese woman who presented with left eye pain. Diagnostic biopsy revealed necrotizing vasculitis with infiltrates of inflammatory cells. Diagnosis was localized granulomatosis with polyangiitis. Combined treatments with corticosteroid plus azathioprine resolved the choroidal mass region. Although treatment with corticosteroid and immunosuppressive agents improves the prognosis of the disease, ocular morbidity is still well recognized. Clinicians should consider a differential diagnosis of GPA in patients with inflammatory choroidal tumors.
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