Extensive pneumatisation of the sphenoid bone: anatomical investigation of the recesses of the sphenoid sinuses and their clinical importance

Jaworek-Troć, Joanna; Walocha, Jerzy; Loukas, Marios; Tubbs, R. Shane; Iwanaga, Joe; Zawilińskí, Jarosław; Brzegowy, Karolina; Zarzecki, J. J.; Curlej-Wądrzyk, Anna; Kucharska, Ewa; Burdan, Franciszek; Janda, Patryk; Zarzecki, Michał

doi:10.5603/fm.a2020.0120

Cited by 7 publications

(10 citation statements)

References 29 publications

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“…Extensive pneumatisation of the sphenoid sinus, namely in the form of the septal recess and / or the vomeral recess, might obstruct the access towards the sphenoid sinus by constricting the sphenoethmoidal recess [2]. The aforementioned recesses were found in 8.78% and 25.34% of the patients of Polish origin respectively [12]. Twigg et al [23] report that they were not able to identify the ostia preoperatively on CT scans in 25% of their cases and they put it down to the fact that its dimensions might have been too small for the volume of the slices obtained by the CT.…”

Section: Discussionmentioning

confidence: 99%

“…Notwithstanding, the sphenoid sinuses are to date assessed from every possible angle due to their vastly complicated and varied anatomy. Some of the most recognizable variants include their dimensions, extensive pneumatisation and hence presence of recesses, as well as relation to the neighboring neurovascular entities, namely the internal carotid canal [10][11][12][13][14][15][16]22].…”

Section: Introductionmentioning

confidence: 99%

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A computed tomography comprehensive evaluation of the ostium of the sphenoid sinus and its clinical significance

et al. 2022

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Background: The purpose of this research was to evaluate the size of the sphenoid sinuses' ostia, the distance between them and the distance between the medial margin of the ostia and the median line in the Polish adult population. Materials and methods:The analysis was undertaken as a retrospective study of 296 computed tomography (CT) scans of patients (147 females, 149 males) with no comorbidities in their sphenoid sinuses. The paranasal sinuses were investigated by using Spiral CT Scanner (Siemens Somatom Sensation 16), in the option Siemens CARE Dose 4D, without administering any contrast medium. Having obtained transverse planes, multiplans reconstruction tool was used in order to glean sagittal and frontal planes. Results:The average size of both sphenoid sinuses ostia was 0.31 cm for both genders (for females ranging from 0.1 to 0.5 cm and from 0.1 to 0.6 cm for males). The mean distance between both sphenoid sinuses ostia was 0.6 cm for both genders (the range for females was 0.1-1.4 cm, whereas 0.1-1.8 cm for males). The average distance between the medial margin of the ostium and the median line was 0.32 cm for both genders (0.31 cm for females in the range of 0-0.9 cm and 0.32 cm for males in the range of 0-1 cm).Conclusions: Intraoperative identification of the sphenoid sinus ostia might prove difficult and their inadequate excision could lead to potential iatrogenic complications, hence detailed anatomical descriptions are still warranted in specific populations in order to perform safe and effective procedures.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A computed tomography comprehensive evaluation of the ostium of the sphenoid sinus and its clinical significance

et al. 2022

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“…Moreover, CT scans allow the differentiation of inflammatory, benign, and malignant sinonasal pathologies [2]. In particular, the identification of potentially dangerous anatomical characteristics, such as the depth of the frontal skull base or the course and bony coverage of the optic nerve and internal carotid artery, are of central importance to minimize the risks of the operation [3][4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…A profound understanding of the sinonasal anatomy and its variations is indispensable to safely perform FESS. Preoperative CT scans help to precisely plan a surgical roadmap that highlights any potentially hazardous anatomical features, and by delineating the degree of disease, prevent unneeded dissections in disease-free parts of the paranasal sinuses [6][7][8][10][11][12]. Furthermore, even though understanding of sinonasal pathologies, surgical approaches as well as radiological imaging have undergone an evolution in both content and structure [13], radiologic reporting has just started to evolve over the course of the past years.…”

Section: Introductionmentioning

confidence: 99%

ENT Residents Benefit from a Structured Operation Planning Approach in the Training of Functional Endoscopic Sinus Surgery

et al. 2021

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Background and Objectives: Preoperative planning utilizing computed tomographies (CT) is of utmost importance in functional endoscopic sinus surgery (FESS). Frequently, no uniform documentation and planning structures are available to residents in training. Consequently, overall completeness and quality of operation planning may vary greatly. The objective of the present study was to evaluate the impact of a structured operation planning (SOP) approach on the report quality and user convenience during a 4-day sinus surgery course. Materials and Methods: Fifteen participant were requested to plan a FESS procedure based on a CT scan of the paranasal sinuses that exhibited common pathological features, in a conventional manner, using a free text. Afterwards, the participants reevaluated the same scans by means of a specifically designed structured reporting template. Two experienced ENT surgeons assessed the collected conventional operation planning (COP) and SOP methods independently with regard to time requirements, overall quality, and legibility. User convenience data were collected by utilizing visual analogue scales. Results: A significantly greater time expenditure was associated with SOPs (183 s vs. 297 s, p = 0.0003). Yet, legibility (100% vs. 72%, p < 0.0001) and overall completeness (61.3% vs. 22.7%, p < 0.0001) of SOPs was significantly superior to COPs. Additionally, description of highly relevant variants in anatomy and pathologies were outlined in greater detail. User convenience data delineated a significant preference for SOPs (VAS 7.9 vs. 6.9, p = 0.0185). Conclusions: CT-based planning of FESS procedures by residents in training using a structured approach is more time-consuming while producing a superior report quality in terms of detailedness and readability. Consequently, SOP can be considered as a valuable tool in the process of preoperative evaluations, especially within residency.

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“…Undoubtedly sphenoid sinuses are an anatomical entity with one of the most variant anatomy, concerning namely its septation, proximity to the nearby crucial neurovascular structures, pneumatisation patterns and others [19][20][21][22][23][24][25][26][27]34]. Notwithstanding, there is still a constant need for new reports regarding their variations due to the fact that they are of immense importance namely in functional endoscopic sinus surgery (FESS) and transnasal transsphenoidal approaches for the pituitary surgery and medical professionals are still poorly acquainted with some of the anatomical features (e.g.…”

Section: Introductionmentioning

confidence: 99%

Agenesis of the sphenoid sinus and a single sphenoid sinus: a computed tomography anatomical evaluation

et al. 2021

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Extensive pneumatisation of the sphenoid bone: anatomical investigation of the recesses of the sphenoid sinuses and their clinical importance

Abstract: Extensive pneumatisation of the sphenoid bone-anatomical investigation of the recesses of the sphenoid sinuses and their clinical importance

Cited by 7 publications

References 29 publications

A computed tomography comprehensive evaluation of the ostium of the sphenoid sinus and its clinical significance

A computed tomography comprehensive evaluation of the ostium of the sphenoid sinus and its clinical significance

ENT Residents Benefit from a Structured Operation Planning Approach in the Training of Functional Endoscopic Sinus Surgery

Agenesis of the sphenoid sinus and a single sphenoid sinus: a computed tomography anatomical evaluation

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