Variations of Surgicalanatomy in and Around Sphenoid Sinus: A Computed Tomographic Study

Abstract

Radiological anatomy is evaluated in three dimensions for preoperative and paroperative sur-gical planning, which helps the surgeon to identify his or her limits of dissection during sur-gery and avoid complications. Patients attending OPD at Institute of Otorhinolaryngology and Head & Neck Surgery, Kol-kata, India with features of sinonasal disease were advised CT scan depending upon the symptoms and course of the disease. 100 study subjects (200 sides) were selected during the study period between 01/01/2019 to 30/06/2020. Septa related directly related to ICA in 31%(n=31) cases of whom 12 patients (12%), 8 pa-tients (8%) and 11 patients (11%) had septa related to right ICA, left ICA and bilaterally ICA respectively. Septa attachment to optic nerve is seen in 27%(n=27) patients, of whom 10 patients (10%), 11 patients (11%) and 6 patients (6%) had attachment related to right optic nerve, left optic nerve and both optic nerves, respectively. On the right side ICA protrusion and pneumatization of ACP were both present in 8(8%) patients and on the left side in 7(7%) patients. Chi-Square test indicated a statistically significant association (P < 0.001). Pneumatized ACP and ON protrusion consistently en-countered on the right and left side in 7 patients (7%) and 8 patients (8%) respectively. Chi-Square test indicated a significant association between ACP pneumatization and ON protru-sion (P<0.001). This resolution helped in better demonstration of complicated sphenoid sinus anatomy well. Hence, we support 1 mm triplaner CT Scans for preoperative imaging assessment for all sinus surgeries.