Relationship between sphenoid sinus volume and accessory septations: A 3D assessment of risky anatomical variants for endoscopic surgery

Abstract

Sphenoid sinus accessory septations involve serious complications during their removal for the injury of the internal carotid artery (ICA) and the optic nerve (ON). The relationships of this anatomical variant with sphenoid size still remain unclear. In the present study, 260 patients (equally divided among sexes, aged between 18 and 92 years) were retrospectively assessed. Number of accessory septations and their relationship with ICA and ON were recorded. The 3D model of sphenoid sinuses was extracted. Pearson's coefficient was calculated to assess correlations between the volume of sphenoid sinuses and the number of septations (P < 0.05). Sexrelated differences in prevalence of septations inserted onto ICA or ON were assessed through chi-square test (P < 0.05). Differences in volume between patients with and without ICA or ON septal insertions were assessed through Mann-Whitney test (P < 0.05). In most of the cases, two septations were found (24.6%), whereas only 21.9% of patients did not show any septum. ICA and ON septal insertions were found in 20.8% and 7.7% of cases, respectively. Number of septations significantly increased with sinus volume, independently from sex (P < 0.001). Moreover, volume was significantly higher in patients with ICA septal insertion (P < 0.001), whereas no difference was found between subjects with and without ON septal insertion (P > 0.05). The present study first proved that septations and probability of ICA insertion are related with sphenoid volume. On the other side, ON insertion does not depend upon sphenoid sinuses size. Anat Rec, 303:1300-1304, 2020.

Prevalence of accessory septations of sphenoid sinus in pediatric population: Applications to endoscopic sinus surgery

“…First, prevalence of accessory septation did not show significant differences according to sex or age and is similar to the same value found in the adult population (Gibelli et al, 2019b): this means that in each age range the same percentage of individuals is affected by this variant. In addition, accessory septations can be found since the age of 10 years.…”

“…Another interesting result concerns the prevalence of septal insertion on ICA which does not change according to sex or age, and again is close to the same value found in adults of the same population group (Gibelli et al, 2019b). However, this variant was mainly verified since the age of 13 years.…”

“…On the other side, septal insertion on ICA ranges between 31 and 89% (Abdullah et al, 2001; Fernandez‐Miranda et al, 2009). In Italy, the prevalence of accessory septations and septal insertion on ICA reached 87.1 and 20.8%, respectively (Gibelli et al, 2019b).…”

Sphenoid Sinus: Pneumatization and Septation Patterns in a Hispanic Population

“…Their pneumatization process starts between the third and the fourth year of life, ending around the age of 16 years. Pneumatization of the sphenoid bone frequently is asymmetrical and might extend to an anterior clinoid process (ACP), posterior clinoid process, greater wings of the sphenoid bone (GWS), ORL 2021;83:362-371 DOI: 10.1159/000514458 pterygoid process (PP), and dorsum sellae (DS) [1]. This complex anatomy is further complicated by the different complete or incomplete septation patterns that could be present [2].…”

Segmentation procedures for the assessment of paranasal sinuses volumes

“…described no significant difference, 16 whereas Gibelli et al. 23 stated that septations number significantly increased with sinus volume and that SS volumes were significantly higher in patients with internal carotid artery septal insertion.…”