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Ahmed J, Namrata, Sujir N, Shenoy N, Natarajan S, Muralidharan A, Shetty AC. A comparative analysis of sphenoid and frontal sinuses using cone beam computed tomography for sex determination. J Oral Biol Craniofac Res 2024; 14:478-483. [PMID: 38984210 PMCID: PMC11231540 DOI: 10.1016/j.jobcr.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/12/2024] [Accepted: 05/10/2024] [Indexed: 07/11/2024] Open
Abstract
Objectives This study aimed to evaluate linear measurements of the frontal sinus (FS) and sphenoid sinus (SS) for sex identification on cone beam computed tomography (CBCT) images. Methods A comparative CBCT analysis was conducted on 200 full field of view (FOV) scans taken as part of routine dental investigations. Dimensions of the bilateral frontal and sphenoid sinuses were measured. Intra- and interobserver reliability were calculated. Independent t tests were used to compare the various parameters between sexes. Stepwise discriminant function analysis was used to determine sex. Additionally, the receiver operating characteristic (ROC) curve, area under the curve (AUC), sensitivity, and specificity were also determined. A p value < 0.05 was considered significant. Results A total of 200 CBCT scans were included in the study. The mean age (±SD) among males was 25.66 (±7.11) and that among females was 24.64 (±5.12). The ROC curve revealed that the right length of the frontal sinus showed the greatest accuracy in sex identification in comparison to other linear measurements of the FS and SS. The results of our study indicated that the equation obtained from stepwise discriminant function analysis can aid in sex determination with an accuracy of 76.5 %. Conclusion Our findings support the sexual dimorphism of linear measurements of FS and SS. There was an improvement in the accuracy of sex prediction when the linear measurements of FS and SS were considered in combination rather than in isolation. The derived equation can be an adjunctive tool for sex identification for the representative population.
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Affiliation(s)
- Junaid Ahmed
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Namrata
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Nanditha Sujir
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Nandita Shenoy
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Srikant Natarajan
- Department of Oral Pathology & Microbiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Archana Muralidharan
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Ashwin C. Shetty
- Department of Dental Education, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Barros FD, Serra MDC, Kuhnen B, Scarso Filho J, Gonçalves M, Gonçalves V, Fernandes CMDS. Sphenoid sinuses' volume and area analysis of Brazilian individuals' CBCTs, related to sex, age, skin color, and nutritional status using DDS-Pro™ software. Forensic Sci Med Pathol 2024; 20:462-471. [PMID: 37329397 DOI: 10.1007/s12024-023-00666-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 06/19/2023]
Abstract
The purpose of this study was to analyze the volume and area of sphenoid sinuses of Brazilian individuals' cone-beam computed tomography (CBCT) images using the beta version of the DDS-Pro™ 2.14.2_2022 software (DPP Systems, Czestochowa, Poland), to assess a potential correlation to sex, age, skin color, and nutritional status, and to evaluate differences between the right and left sides. Three-dimensional volume and area measurements were made with the software using CBCT images of 113 living Brazilian individuals of both sexes (67 females and 46 males). TEM, rTEM, and R were used to assess the reproducibility of inter- and intra-examiner measurements. The measurement means were estimated with 95% confidence intervals according to sex and age group. There were no significant differences between the left and right sides for both volume and area and between the sexes and black and white individuals. Volume and area were significantly higher in 18 years or older (p < 0.05) and in individuals with normal body mass index (BMI) (p < 0.05). The obtained results do not allow indicating the use of sphenoid sinuses volume and area measurements to estimate sexual dimorphism, and the same occurred for skin color. However, such measures can help to estimate age. Further studies are suggested with a larger sample, especially for the nutritional status variable.
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Affiliation(s)
- Franciéllen de Barros
- Department of Community Dentistry, School of Dentistry, Araraquara, São Paulo State University - Unesp, Rua Humaitá 1680, Araraquara, SP, 14.801-903, Brazil
| | - Mônica da Costa Serra
- Department of Community Dentistry, School of Dentistry, Araraquara, São Paulo State University - Unesp, Rua Humaitá 1680, Araraquara, SP, 14.801-903, Brazil.
| | - Barbara Kuhnen
- Department of Community Dentistry, School of Dentistry, Araraquara, São Paulo State University - Unesp, Rua Humaitá 1680, Araraquara, SP, 14.801-903, Brazil
| | - José Scarso Filho
- Department of Diagnosis and Surgery, School of Dentistry, Araraquara, São Paulo State University - Unesp, Rua Humaitá 1680, Araraquara, SP, 14.801-903, Brazil
| | - Marcelo Gonçalves
- Department of Diagnosis and Surgery, School of Dentistry, Araraquara, São Paulo State University - Unesp, Rua Humaitá 1680, Araraquara, SP, 14.801-903, Brazil
| | - Victor Gonçalves
- Department of Diagnosis and Surgery, School of Dentistry, Araraquara, São Paulo State University - Unesp, Rua Humaitá 1680, Araraquara, SP, 14.801-903, Brazil
| | - Clemente Maia da Silva Fernandes
- Department of Community Dentistry, School of Dentistry, Araraquara, São Paulo State University - Unesp, Rua Humaitá 1680, Araraquara, SP, 14.801-903, Brazil
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Gurlek Celik N, Akman B. Analysis of sphenoid sinus and ethmoid sinus volume and asymmetry by sex: A 3D-CT study. Surg Radiol Anat 2024; 46:551-558. [PMID: 38321355 DOI: 10.1007/s00276-024-03319-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 01/31/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE To measure the volume of the sphenoid and ethmoid sinuses and to analyse the asymmetry index values by age/gender. METHODS Three-dimensional (3D) Computed Tomography (CT) images of 150 individuals (75 females, 75 males) of both sexes between the ages of 18-75 were included in our study. Sphenoid and ethmoid sinus volumes were measured using the 3D Slicer software package on these images, and the asymmetry index was calculated. RESULTS In our study, mean sphenoid sinus volume (female right: 4264.4 mm3, left: 3787.1 mm3; male right: 5201.1 mm3, left: 4818.2 mm3) and ethmoid sinus volume (female right: 3365.1 mm3, left: 3321.2 mm3; male right: 3440.9 mm3, left: 3459.5 mm3) were measured in males and females. Left sphenoid sinus values of males were statistically higher than females (p = 0.036). No statistically significant relationship existed between age, sinus volumes, and asymmetry index (p > 0.05). A statistically weak positive correlation existed between males' left sphenoid and ethmoid sinus volume (rho = 0.288; p = 0.012). There was no statistical relationship between asymmetry index in the whole group (p > 0.05). A statistically weak negative correlation was found between sphenoid and ethmoid sinus asymmetry index in males (rho=-0.352; p = 0.002). There was no statistical relationship between asymmetry index in females (p > 0.05). CONCLUSION Knowing paranasal sinus morphology, morphometry, and asymmetry index value will be significant for preoperative and postoperative periods.
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Affiliation(s)
- Nihal Gurlek Celik
- Department of Anatomy, Faculty of Medicine, Amasya University, Amasya, 05100, Turkey.
| | - Burcu Akman
- Department of Radiology, Faculty of Medicine, Amasya University, Amasya, 05100, Turkey
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Serindere M, Belgin CA. Evaluation of the relationship between sphenoid sinus morphology and area and volume by computed tomography. Oral Radiol 2024; 40:138-147. [PMID: 37749336 DOI: 10.1007/s11282-023-00711-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 09/04/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVES The aim of this study is to investigate the effect of sphenoid sinus pneumatization types, Onodi cell (OC), internal carotid artery (ICA), optic nerve (ON) on sinus volume and area on computed tomography (CT) images. METHODS The CT images of 150 patients were evaluated. Sphenoid sinus pneumatization types, OC prevalence, protrusion and dehiscence of ICA and ON, the volume and area were evaluated. RESULTS The sinus volume and area were statistically higher in patients with bilateral protrusion of ICA and ON then patients without protrusion of ICA and ON. The mean volume and area of sinus were 9949.4 ± 351.0 mm3 and 4570.9 ± 1604.9 mm2, respectively. The volume and area of sphenoid sinus did not differ significantly between groups with and without OC. The postsellar b type sphenoid sinus had the highest volume, while conchal type has the least volume. CONCLUSIONS Bilateral protrusion and dehiscence of ICA and bilateral protrusion of ON caused a significant increase in the sphenoid sinus volume and area. The presence of ICA and ON, the pneumatization of the sinus is an anatomical structure that can affect the sinus volume and area. Before the operation, three-dimensional evaluation should be performed to determine whether these structures are bilateral/unilateral and it should be remembered that the sinus volume and area can change.
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Affiliation(s)
- Mehmet Serindere
- Department of Radiology, Hatay Education and Research Hospital, Hatay, Turkey.
| | - Ceren Aktuna Belgin
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Hatay Mustafa Kemal University, Hatay, Turkey
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Hekimoglu Y, Sasani H, Etli Y, Keskin S, Tastekin B, Asirdizer M. Sex Estimation From the Paranasal Sinus Volumes Using Semiautomatic Segmentation, Discriminant Analyses, and Machine Learning Algorithms. Am J Forensic Med Pathol 2023; 44:311-320. [PMID: 37235867 DOI: 10.1097/paf.0000000000000842] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
ABSTRACT The aims of this study were to determine whether paranasal sinus volumetric measurements differ according to sex, age group, and right-left side and to determine the rate of sexual dimorphism using discriminant function analysis and machine learning algorithms. The study included paranasal computed tomography images of 100 live individuals of known sex and age. The paranasal sinuses were marked using semiautomatic segmentation and their volumes and densities were measured. Sex determination using discriminant analyses and machine learning algorithms was performed. Males had higher mean volumes of all paranasal sinuses than females ( P < 0.05); however, there were no statistically significant differences between age groups or sides ( P > 0.05). The paranasal sinus volumes of females were more dysmorphic during sex determination. The frontal sinus volume had the highest accuracy, whereas the sphenoid sinus volume was the least dysmorphic. In this study, although there was moderate sexual dimorphism in paranasal sinus volumes, the use of machine learning methods increased the accuracy of sex estimation. We believe that sex estimation rates will be significantly higher in future studies that combine linear measurements, volumetric measurements, and machine-learning algorithms.
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Affiliation(s)
| | - Hadi Sasani
- Medical Faculty of Namik Kemal University, Istanbul
| | - Yasin Etli
- Specialist of Forensic Medicine. Department of Forensic Medicine, Medical Faculty Hospital of Selcuk University, Konya
| | - Siddik Keskin
- Biostatistics Department, Medical School of Van Yuzuncu Yil University, Van
| | - Burak Tastekin
- Clinic of Forensic Medicine, Republic of Turkey Ministry of Health Ankara City Hospital, Ankara
| | - Mahmut Asirdizer
- Forensic Medicine Department, Medical Faculty of Bahçeşehir University, Istanbul
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Taylor A, Habib AR, Kumar A, Wong E, Hasan Z, Singh N. An artificial intelligence algorithm for the classification of sphenoid sinus pneumatisation on sinus computed tomography scans. Clin Otolaryngol 2023; 48:888-894. [PMID: 37488094 DOI: 10.1111/coa.14088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 02/17/2023] [Accepted: 06/18/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Classifying sphenoid pneumatisation is an important but often overlooked task in reporting sinus CT scans. Artificial intelligence (AI) and one of its key methods, convolutional neural networks (CNNs), can create algorithms that can learn from data without being programmed with explicit rules and have shown utility in radiological image classification. OBJECTIVE To determine if a trained CNN can accurately classify sphenoid sinus pneumatisation on CT sinus imaging. METHODS Sagittal slices through the natural ostium of the sphenoid sinus were extracted from retrospectively collected bone-window CT scans of the paranasal sinuses for consecutive patients over 6 years. Two blinded Otolaryngology residents reviewed each image and classified the sphenoid sinus pneumatisation as either conchal, presellar or sellar. An AI algorithm was developed using the Microsoft Azure Custom Vision deep learning platform to classify the pattern of pneumatisation. RESULTS Seven hundred eighty images from 400 patients were used to train the algorithm, which was then tested on a further 118 images from 62 patients. The algorithm achieved an accuracy of 93.2% (95% confidence interval [CI] 87.1-97.0), 87.3% (95% CI 79.9-92.7) and 85.6% (95% CI 78.0-91.4) in correctly identifying conchal, presellar and sellar sphenoid pneumatisation, respectively. The overall weighted accuracy of the CNN was 85.9%. CONCLUSION The CNN described demonstrated a moderately accurate classification of sphenoid pneumatisation subtypes on CT scans. The use of CNN-based assistive tools may enable surgeons to achieve safer operative planning through routine automated reporting allowing greater resources to be directed towards the identification of pathology.
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Affiliation(s)
- Alon Taylor
- Department of Otolaryngology - Head and Neck Surgery, Westmead Hospital, Westmead, New South Wales, Australia
| | - Al-Rahim Habib
- Department of Otolaryngology - Head and Neck Surgery, Westmead Hospital, Westmead, New South Wales, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Ashnil Kumar
- School of Biomedical Engineering, Faculty of Engineering, University of Sydney, Sydney, New South Wales, Australia
- ARC Training Centre for Innovative BioEngineering, Sydney, New South Wales, Australia
| | - Eugene Wong
- Department of Otolaryngology - Head and Neck Surgery, Westmead Hospital, Westmead, New South Wales, Australia
- Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Zubair Hasan
- Department of Otolaryngology - Head and Neck Surgery, Westmead Hospital, Westmead, New South Wales, Australia
| | - Narinder Singh
- Department of Otolaryngology - Head and Neck Surgery, Westmead Hospital, Westmead, New South Wales, Australia
- Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Lazzeroni M, Accorona R, Capaccio P, Pignataro L, Cellina MI, Gibelli DM, Sforza C. Morphological and Metrical Relationships Between Sphenoid Sinus and Sella Turcica: Possible Applications in Transnasal Transsphenoidal Surgery. J Craniofac Surg 2023; 34:1357-1360. [PMID: 36907831 DOI: 10.1097/scs.0000000000009241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 11/08/2022] [Indexed: 03/14/2023] Open
Abstract
INTRODUCTION Transsphenoidal surgeries imply the risk of intraoperative lesions to the neurovascular structures surrounding the sphenoid sinus (SS). Aim of the present study is to assess the metrical and morphologic relationships existing between SS and sella turcica (ST). MATERIALS AND METHODS Two hundred computed tomography-scans of patients were selected. For each patient volumes of SS were calculated from their 3-dimensional models segmented through ITK-SNAP program. Variants of SS in pneumatisation and sellar diameters [antero-posterior (AP) diameter, depth, and length] were evaluated on each computed tomography-scan. Correlations among different measurements were assessed through Spearman test ( P <0.01), whereas associations between sellar parameters and presence of pneumatisation variants were assessed through Mann-Whitney test ( P <0.01). RESULTS In males, pneumatization of the greater wings was related to smaller AP diameter ( P <0.01) and depth of ST ( P <0.01), whereas in females lower values of depth were found in patients with pneumatization of the pterygoid processes ( P <0.01). In both sexes, a positive correlation was found between AP diameter and, respectively, length and depth of ST ( P <0.01), together with a negative correlation between volume of SS and depth of ST ( P <0.01). Lastly, in females a positive correlation was found between age and, respectively, length and depth of ST ( P <0.01). CONCLUSIONS The present study highlighted new metrical and morphologic relationships between volume and pneumatisation of SS and diameters of ST. Knowledge of these correlations allows to understand more clearly, in the preoperative setting, the surgical working space. Further studies are needed, especially for what concerns the relationship between sellar measurements and age in females.
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Affiliation(s)
- Matteo Lazzeroni
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 31
- Department of Otorhinolaryngology-Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | - Remo Accorona
- Department of Otorhinolaryngology-Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | - Pasquale Capaccio
- Department of Otorhinolaryngology-Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
- Department of Biomedical, Surgical and Dental Sciences, University of Milan
| | - Lorenzo Pignataro
- Department of Otorhinolaryngology-Head and Neck Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
- Department of Clinical Sciences and Community Health, University of Milan
| | - Michaela Iva Cellina
- Radiology Department, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde 3, 20121, Milan, Italy
| | - Daniele Maria Gibelli
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 31
| | - Chiarella Sforza
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Luigi Mangiagalli 31
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Iturralde-Garrote A, Sanz JL, Forner L, Melo M, Puig-Herreros C. Volumetric Changes of the Paranasal Sinuses with Age: A Systematic Review. J Clin Med 2023; 12:jcm12103355. [PMID: 37240460 DOI: 10.3390/jcm12103355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/19/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND There are four pairs of paranasal sinuses: maxillary, ethmoidal, frontal, and sphenoidal. It is common to see changes in size and shape throughout life, so understanding the effect of age on sinus volume can help in radiographic studies and in planning dental and surgical procedures in the sinus-nasal region. The aim of the present systematic review was to perform a qualitative synthesis of available studies which assess the volumetric characteristics of the sinuses and their changes according to age. MATERIALS AND METHODS The present review followed PRISMA 2020 guidelines. A systematic advanced electronic search was performed in five databases (Medline (via PubMed), Scopus, Embase, Cochrane, and Lilacs) in June-July 2022. Studies that assessed the volumetric changes of paranasal sinuses with age were eligible for inclusion. A qualitative synthesis of the methodology and results of the included studies was performed. Quality assessment was performed using the NIH quality assessment tool. RESULTS A total of 38 studies were included in the qualitative synthesis. Most authors who studied the maxillary and ethmoidal sinuses concluded that it begins its development from birth until the maximum peak of growth, from which it begins to decrease in volume with age. Results regarding the volumetric changes of the frontal and sphenoidal sinuses are mixed. CONCLUSIONS Based on the results of the studies included in the present review, it can be concluded that the volume of the maxillary and ethmoidal sinus appears to decrease with age. Conclusions on the volumetric changes of the sphenoidal and frontal sinuses require further evidence.
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Affiliation(s)
- Amaya Iturralde-Garrote
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010 Valencia, Spain
| | - José Luis Sanz
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010 Valencia, Spain
| | - Leopoldo Forner
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010 Valencia, Spain
| | - María Melo
- Departament d'Estomatologia, Facultat de Medicina I Odontologia, Universitat de València, 46010 Valencia, Spain
| | - Clara Puig-Herreros
- Clínica de Logopedia, Fundació Lluis Alcanyis, Universitat de València, 46010 Valencia, Spain
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Factors affecting the location of sphenoid sinus ostium: a binary logistic regression analysis. Eur Arch Otorhinolaryngol 2023; 280:1757-1764. [PMID: 36219233 DOI: 10.1007/s00405-022-07691-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 10/04/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Sphenoid sinus is a type of sinus surrounded by critical structures so that its injury potential to induce complications during surgery. The purpose of this study was to investigate the factors affecting the location of the sphenoid sinus natural ostium (SSO) to provide valuable data for endoscopic sinus surgery. METHODS Ostiomeatal unit (OMU) computerized tomography (CT) was performed on 198 subjects. Across the left and right sides, 396 evaluation results were obtained. The vertical distance to determine the location of the SSO was analyzed based on Lines 1, 2 and 3 on the sagittal image. The horizontal distance was analyzed based on Lines 4 and 5 on the axial image. The upper, lower, medial and non-medial borders were defined according to the location of the SSO. The presellar, sellar and postsellar types were categorized according to the level of sphenoid sinus pneumatization (SSP) on the sagittal image. The presence and absence of Onodi cells were defined on the coronal image. Binary logistic regression analysis was performed to investigate each factor. RESULTS As the rostrum width of the SSO on the horizontal position increased, the position toward non-medial boarder increased by 4.902 times so that the natural ostium showed a trend of lateralization. For the postsellar type, compared to the presellar type, the position toward the non-medial boarder decreased by 0.223 times, indicating that the postsellar type had the natural ostium showing a trend of medialization. In the presence of Onodi cells, the position toward the lower boarder increased by 2.599 times with a significant association. CONCLUSIONS The results in this study indicated that the presellar type of SSP had the natural ostium exhibiting lateralization with an increase in the rostrum width, whereas the postsellar type had the natural ostium exhibiting medialization with a decrease in the rostrum width. Based on these findings, the methods to widen the natural ostium may be diversified.
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Anatomical study of the maxillary sinus: which characteristics can influence its volume? SURGICAL AND RADIOLOGIC ANATOMY : SRA 2023; 45:81-87. [PMID: 36474022 DOI: 10.1007/s00276-022-03055-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/27/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE To investigate whether there is a relationship between the volume of the maxillary sinus and individual parameters such as gender, side, posterior tooth absence, sinus membrane thickening, bony septa, vertical and sagittal skeletal patterns. METHODS The tomographic volume of the maxillary sinus from 211 individuals (422 sides) was evaluated using Horos DICOM Viewer Software. Bony septa and sinus membrane thickening were classified as absent or present. At the same time, loss of one or more teeth in the posterior region of the maxilla (except for the third molars) was considered. The t test was applied to analyze maxillary sinus volume according to gender, age, side, posterior tooth absence, sinus membrane thickening and bony septa. A one-way analysis of variance (ANOVA) with Tukey's post-hoc test was applied to compare sagittal and vertical patterns. Pearson's correlation coefficient was also used to verify the association between maxillary sinus volume, age and skeletal patterns. RESULTS Concerning the sagittal skeletal pattern, a statistically significant difference was observed between Classes II and III (p = 0.05) and it was confirmed by the Pearson's correlation coefficient (r = - 0.107/p = 0.029). No statistically significant differences were observed between the maxillary sinus volume according to gender (p = 0.06), side (p = 0.37), posterior tooth absence (p = 0.92), sinus membrane thickening (p = 0.47), bony septa (0.89) and vertical skeletal pattern (p = 0.67). No significant differences were observed with age (r = - 0.076/p = 0.109) and the vertical skeletal pattern (r = - 0.078/p = 0.108). CONCLUSION Maxillary sinus volume was influenced by the sagittal skeletal pattern and was higher in Class III individuals.
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Aksakal C, Aktı S, Çeker ME, Subaşı Aksakal B, Sapmaz E, Gökçe E. Development of the sphenoid sinus from newborn to age 18: A computed tomography imaging analysis. Int J Pediatr Otorhinolaryngol 2022; 162:111327. [PMID: 36202021 DOI: 10.1016/j.ijporl.2022.111327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/31/2022] [Accepted: 09/21/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The sphenoid sinus (SS) is an important anatomical formation in terms of its location and relationship with important neurovascular structures. It is essential to evaluate the pneumatization and dimensions of the SS with Computed Tomography (CT) in the preoperative period of transsphenoidal interventions to be performed on tumors located in this region. The aim of this study was to evaluate the correlation of the volume and dimensions of the SS measured with CT with age in the period from birth to 18 years of age. METHODS In this retrospective study, a total of 360 brain, paranasal sinus, temporal bone and maxillofacial CT scans of individuals from birth to 18 years of age were evaluated. The cohort was divided into 18 groups with 20 (10 female, 10 male) patients in each age group. The height, width, length and volume values of the SS were measured on CT and their correlations with age and the differences between genders were evaluated statistically. RESULTS It has been determined that the increases in the size and volume of the SS accelerate especially between 1 and 2 years of age and begins to reach adult dimensions after 12 years of age. Height and length of the sphenoid sinus showed a high correlation coefficient (r = 0.717 and r = 0.731 respectively) with age, while its width and volume showed a moderate correlation coefficient (r = 0.662 and 0.543 respectively). There was no statistically significant difference between the genders in terms of SS height, width, length and volume. CONCLUSIONS SS dimensions and volume showed a logaritmic growth pattern from birth to 18 years. The results of this study may help to better understand the normal development of SS in children and may serve as a reference for more comprehensive CT studies. In addition, it can help surgeons to evaluate the developmental characteristics of SS in surgical interventions for SS in children.
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Affiliation(s)
- Ceyhun Aksakal
- Department of Otolaryngology Head and Neck Surgery, Tokat Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
| | - Serdar Aktı
- Department of Radiology, Erbaa State Hospital, Tokat, Turkey.
| | - Muhammed Erkam Çeker
- Department of Radiology, Tokat Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
| | - Betül Subaşı Aksakal
- Department of Oral Diagnosis and Radiology, Tokat Gaziosmanpaşa University Faculty of Dentistry, Tokat, Turkey.
| | - Emrah Sapmaz
- Department of Otolaryngology Head and Neck Surgery, Tokat Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
| | - Erkan Gökçe
- Department of Radiology, Tokat Gaziosmanpaşa University Faculty of Medicine, Tokat, Turkey.
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Higashino M, Abe S, Sawada M, Yamada H, Ayani Y, Haginomori SI, Kawata R, Matsuoka T, Nakai G, Osuga K, Tanaka E. Development of the Sphenoid Sinus in Japanese Children: A Retrospective Longitudinal Study Using Three-Dimensional Computed Tomography. J Clin Med 2022; 11:jcm11216311. [PMID: 36362538 PMCID: PMC9656594 DOI: 10.3390/jcm11216311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The sphenoid sinus (SS) is located close to vital structures, such as the pituitary gland, and it has significant clinical relevance. This study aimed to clarify the growth pattern of the SS in Japanese children using three-dimensional computed tomography (CT). Methods: Seventy-eight participants with congenital, acquired, or external auditory canal cholesteatoma were recruited and underwent CT more than twice during their treatment. Using the volume-rendered images, the size and volume of the SS were measured. Furthermore, on the scout image, the morphological measurements of the cranial base were determined. Results: The size and volume of the SS increased with age, and peaked at the mean age of 15 years. For males, the volume of the SS was smaller than that of females aged <5 years. The growth rate of the SS was significantly higher in males than in females. The maximum growth rate was detected at the age of 12 years for males and 10 years for females. For females, the increase in the length of the anterior cranial base ceased at approximately 10 years of age and remained constant thereafter. In contrast, for males, the length of the anterior cranial base increased gradually until 15 years of age. Conclusions: Considering the similarity of the periods between the adolescent growth spurt and the maximum growth rate of the SS, changes in the size of the SS may be used as an indicator of the physical growth spurt.
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Affiliation(s)
- Masaaki Higashino
- Department of Otorhinolaryngology, Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan
| | - Susumu Abe
- Department of Comprehensive Dentistry, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8504, Tokushima, Japan
| | - Masaki Sawada
- Yamada Orthodontic Office, Izumiotsu 595-0025, Osaka, Japan
| | - Hiroshi Yamada
- Yamada Orthodontic Office, Izumiotsu 595-0025, Osaka, Japan
| | - Yusuke Ayani
- Department of Otorhinolaryngology, Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan
| | - Shin-Ichi Haginomori
- Department of Otorhinolaryngology, Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan
| | - Ryo Kawata
- Department of Otorhinolaryngology, Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan
| | - Toshihiro Matsuoka
- Department of Diagnostic Radiology, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan
| | - Go Nakai
- Department of Diagnostic Radiology, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan
| | - Keigo Osuga
- Department of Diagnostic Radiology, Faculty of Medicine, Osaka Medical and Pharmaceutical University, Takatsuki 569-8686, Osaka, Japan
| | - Eiji Tanaka
- Department of Orthodontics and Dentofacial Orthopedics, Tokushima University Graduate School of Biomedical Sciences, Tokushima 770-8504, Tokushima, Japan
- Correspondence: ; Tel.: +81-88-633-7356
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Paglia F, Caporlingua A, Armocida D, Rizzo F, Santoro A, D'angelo L. Preoperative 3D volume reconstruction of the posterior wall of the sphenoid sinus with Horos: A free, simple and reliable tool in endoscopic endonasal trans-sphenoidal surgery. NEUROCIRUGIA (ENGLISH EDITION) 2022; 33:219-226. [PMID: 36084958 DOI: 10.1016/j.neucie.2021.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/18/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND The purpose of the study was to create computer-aided design models of the sphenoid sinus with a free-source software in order to perform a preoperative planning during trans-sphenoidal endoscopic surgery (TES) and clarify the three-dimensional anatomical features of the sphenoid sinus and its surrounding structures. METHODS For each patient a 3D volume rendering of the sphenoid sinus was obtained from a thin slice head and maxilla-facial CT scan using a free-source DICOM viewer. The 3D models obtained preoperatively were examined preoperatively by six neurosurgeons in order to identify the boundaries of the sella. RESULTS For the main anatomical landmark, all of the observers were able to recognize the anatomical structure at a rate ranging from 80 to 98%, 28 to 60% and 25 to 58% for expert (n=3), inexpert (n=3) and the entire group of observers (n=6), respectively. The analysis of the data shows that both observation groups presented a lower recognition rate of the following parameters: right and left medial and lateral optocarotid recesses and tumor prominence, however, the sellar prominence, clival recess, planum sphenoidalis, right and left ICA prominence, right and left optic prominences represent the main anatomical landmarks to be recognized during TES immediately before the opening of the sellar floor. CONCLUSIONS The use of a preoperative 3D imaging is not in itself a novelty in the literature, however the fact that a simple tool obtained with a free-source software like Horos can represent a considerable help in surgical practice without resorting to the use of more complex software and expensive represents the real utility of this work.
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Affiliation(s)
- Francesco Paglia
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy
| | | | - Daniele Armocida
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy.
| | - Francesca Rizzo
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy
| | - Antonio Santoro
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy
| | - Luca D'angelo
- Human Neurosciences Department, Neurosurgery Division, "Sapienza" University, Italy
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Anatomical Variants, Pneumatization Classification, and Volumetric Studies of the Sphenoid Sinus With High-Resolution Computed Tomography. J Craniofac Surg 2021; 32:2542-2545. [PMID: 34705363 DOI: 10.1097/scs.0000000000007570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Aimed to explore the correlation between the volume of the sphenoid sinuses (SS) and sex, age, pneumatization and its anatomical variant types. MATERIAL AND METHODS Retrospectively evaluated high-resolution computed tomography images of 170 individuals; were studied by ITK-SNAP software to measure the volume of SS. RESULTS The average volume of SS was a significant difference between the gender, the volume of SS in the elderly group (≥65 years old) showed a downward trend. The volume of the SS in the variants of the anterior clinoid processes, pterygoid processes, greater wings, and clivus were significantly higher than in the nonvariants (P < 0.05). With the expansion of pneumatization, the optic nerve (CNII) type 3-4, the internal carotid artery (ICA) type 2-3 and the septal insertion on the ICA have a larger volume, while the occurrence of septal insertion on only the CNII was not correlated with the volume (P > 0.05). CONCLUSIONS AND SIGNIFICANCE The volume of SS is closely related to age, sex, the type of pneumatization and anatomical variation. High-resolution computed tomography can facilitate a precise study of anatomical variations and adjacent structures and help ensure the safety of an operation.
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Correlation Between Anatomic Variations of Sphenoid Sinuses and Pituitary Adenoma. J Craniofac Surg 2021; 32:1685-1688. [PMID: 33273198 DOI: 10.1097/scs.0000000000007293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Many persons have studied relationship between anatomic variations (AVs) of sphenoid sinuses (SS) and paranasal disease, but no research has been done to reveal the correlation between AVs of SS and sellar region lesions. OBJECTIVE To compare AVs of SS between sellar region lesions and healthy persons and analyze factors affecting the volume of SS and explore the correlation between AVs of SS and pituitary adenomas (PAs). METHODS Clinical data of 53 PAs as experiment group and 30 healthy persons as control team was reviewed. Computed tomography images of SS performed at Tianjin Huanhu Hospital were studied. The AVs of SS including degree of pneumatization, type of intersinus septum (IS), and volume of SS were evaluated by ITK-SNAP software. RESULTS Age, gender, degree of pneumatization, and type of IS had no significant difference between groups, while the volume of SS in experiment group was smaller than that in control group (P < 0.05). The volume of SS was associated with age, sex, degree of pneumatization, type of IS in control group, and degree of pneumatization, type of IS in experiment group. In experiment group, patients with postoperative pathological examination ki67 ≥ 3% had bigger volume and higher recurrent rate (P < 0.05). CONCLUSION Visualizing different orientations and 3D model of SS is conducive to the success of trans-sphenoid surgery. Pituitary adenomas can deform the SS leading to smaller volume. The volume of SS can be a factor used to predict the outcome of PAs.
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Singh P, Hung K, Ajmera DH, Yeung AWK, von Arx T, Bornstein MM. Morphometric characteristics of the sphenoid sinus and potential influencing factors: a retrospective assessment using cone beam computed tomography (CBCT). Anat Sci Int 2021; 96:544-555. [PMID: 34232466 PMCID: PMC8338843 DOI: 10.1007/s12565-021-00622-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 06/09/2021] [Indexed: 11/27/2022]
Abstract
The present study aimed to evaluate the morphological characteristics of the sphenoid sinus (SS), and the impact of potential influencing factors on the morphometric features using CBCT imaging. CBCT scans of 148 patients, aged between 15 and 85 (32.88 ± 15.33) years were retrospectively evaluated. DICOM files from the CBCT scans were imported into semi-automatic software and the SS of each patient was assessed for the morphological characteristics including configuration, symmetry, extension, shape, septation, volume, and maximum diameter. Furthermore, potential influencing factors such as age, gender, side, and sinus condition were analysed. A significant association was observed between sinus extension and age. Septation was also found to be significantly associated with age, gender and sinus condition. Besides, sinus volume was significantly associated with gender and sinus condition. No significant influence of shape and side on the morphometric features was noticed. The average volume and diameter of the SS were 6576.92 ± 3748.12 mm3 and 30.48 ± 9.28 mm, respectively. In conclusion, the present findings indicate that age, gender and sinus condition have a significant impact on the morphometric characteristics of the SS. Mature sinuses exhibit a post-sellar extension pattern until middle age. In addition, males, and sinuses with healthy sinus condition have larger volumes compared to females and pathological sinuses.
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Affiliation(s)
- Pradeep Singh
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Kuofeng Hung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Deepal Haresh Ajmera
- Orthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Andy Wai Kan Yeung
- Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Thomas von Arx
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Michael M Bornstein
- Department of Oral Health & Medicine, University Center for Dental Medicine Basel UZB, University of Basel, Mattenstrasse 40, 4058, Basel, Switzerland.
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Preoperative 3D volume reconstruction of the posterior wall of the sphenoid sinus with Horos: A free, simple and reliable tool in endoscopic endonasal trans-sphenoidal surgery. Neurocirugia (Astur) 2021. [DOI: 10.1016/j.neucir.2021.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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18
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Volumetric Investigation of Sphenoid Sinus in an Elderly Population. J Craniofac Surg 2021; 31:2346-2349. [PMID: 33136888 DOI: 10.1097/scs.0000000000006872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The aims of this study were to determine the sphenoid sinus volume in an Austrian population, evaluate the relationship between volume and different types of pneumatization and investigate possible age-related sphenoid sinus volume degeneration in the elderly. A total of 50 human cadaver including 25 male and 25 female samples (=100 sphenoid sinuses, age range 65-100, mean age 84.52 ± 9.50) were selected to obtain volume and anatomical variants of pneumatization by using sphenoid sinus casts, made of quadrofunctional hydrophilic addition reaction silicone. The mean sphenoid sinus volume was 4.79 ± 2.39 cm. Males showed statistically significant larger sinus volumes than females (P = 0.048). The volume differed statistically significant for the different types of pneumatization (P < 0.001). The combined type of sphenoid sinus pneumatization presented the largest volume with 7.20 cm, followed by lateral, clival, sphenoid body, presellar, and conchal sinus type with 5.72, 5.63, 4.25, 2.08, and 0.5 cm, respectively. No significant correlation between age and sphenoid sinus volume was found (P = 0.707). This study highlights the close relationship between volume and morphology of sphenoid sinus and confirms ethnic variability. Moreover, our data shows no age-related volume degeneration.
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Ramos BC, Manzi FR, Vespasiano AI. Volumetric and linear evaluation of the sphenoidal sinus of a Brazilian population, in cone beam computed tomography. J Forensic Leg Med 2020; 77:102097. [PMID: 33310643 DOI: 10.1016/j.jflm.2020.102097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 12/09/2022]
Abstract
The determination of sex from skeletal remains has been widely used in biological profile reconstruction since these are some of the last structures to perish after death. The sphenoid sinus is located deeply in the skull and is enveloped by diverse structures within the sphenoid body. It is, therefore, less predisposed to injuries and/or pathological changes. The aim of this study is to evaluate the possibility of determining sex in a Brazilian population by means of linear and volumetric measurements of the sphenoid sinus, in addition to identifying and quantifying the presence of extensions of this sinus in cone beam computed tomography (CBCT) scans. In total 268 CBCT scans were analysed, from patients aged between 22 and 70 years old, of which 145 were female, and 123 were male. The images, representative of a Brazilian population, were selected by a dental radiologist from a CBCT image bank. The volumetric measurements were made by means of the segmentation software ITK-SNAP 3.0® and the linear inferio-superior, latero-lateral and anteroposterior measurements, as well as the presence of extensions of the sphenoidal sinus, were made using the CS Imaging Software®. The results of this study suggested that when comparing men and women, there were no statistical differences in the linear measurements and extensions of the sphenoidal sinus, although the values were considerable in the extensions for the pterygoid processes and greater wings of the sphenoid bone, particularly in women. However, there was a statistically significant difference when the sphenoidal sinus volume was compared, as it was larger for men (11.364 mm³ ± 4.229 mm³) than for women (10.000 mm³ ± 3.615 mm³). In summary, the sphenoidal sinus volumetric measurements in CBCT exams are useful for determining the sex of unknown individuals.
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Affiliation(s)
- Barbara Couto Ramos
- Departament of Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Belo Horizonte, Minas Gerais, Brazil.
| | - Flávio Ricardo Manzi
- Departament of Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Belo Horizonte, Minas Gerais, Brazil.
| | - Amaro Ilídio Vespasiano
- Departament of Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Belo Horizonte, Minas Gerais, Brazil.
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20
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KOÇ A. Are Maxillary and Sphenoid Sinus Volumes Deterministic for Gender and Age Estimation? A Cone Beam Computed Tomography Study. CUMHURIYET DENTAL JOURNAL 2020. [DOI: 10.7126/cumudj.795870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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21
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Anatomical and Volumetric Analysis of the Sphenoid Sinus by Semiautomatic Segmentation of Cone Beam Computed Tomography. J Craniofac Surg 2020; 32:1166-1170. [PMID: 33181613 DOI: 10.1097/scs.0000000000007209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This investigation was performed to analyze and evaluate anatomical and volumetric data of the sphenoid sinus by semiautomatic segmentation of cone beam computed tomography (CBCT) datasets.This analysis was carried out on cone beam computed tomography images of 100 patients. By using the discretionary software "ITK-Snap", the volumetric investigation of 197 sphenoid sinuses was conducted. The statistical analyses were carried out by using the paired and independent Student t-test. In addition, the Pearsons chi-square test was performed. P values P < 0.05 were considered significant.The volumetric mean was 4.438 ± 2.434 cm for the right and 4.809 ± 3.000 for the left side. Results did not indicate statistically significant differences according to the side, irrespective of gender (P > 0.05). The further investigation of differences between male and female patients did assess significant results (P < 0.05), males (10.477 ± 3.851 cm) present a larger total sinus volume than females (8.219 ± 3.574 cm). In accordance to patients' age (median 54 years), smaller volumes were related to younger patients and larger volumes to older ones. But, no statistically significant results in accordance to age could be detected (χ = 1.258; P > 0.05).Endoscopic sinus surgery of the vulnerable and intricate anatomy of the sphenoid sinus requires an explicit knowledge and orientation about the anatomical variations such as septums and volumetric capacity. Concerning this matter, semiautomatic segmentation of CBCT images can aid the surgeon in preoperative planning. Our investigation shows that a small sinus volume, that is, affecting female patients and a complex sinus anatomy by the occurrence of a septum, especially located close to neurovascular structures could essentially aggravate endoscopic sphenoid sinus surgery. In this regard, volumetric analysis of the sphenoid sinus by CBCT images can provide presurgical information and facilitates an individualized treatment.
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Cellina M, Gibelli D, Cappella A, Toluian T, Pittino CV, Carlo M, Oliva G. Segmentation procedures for the assessment of paranasal sinuses volumes. Neuroradiol J 2020; 34:13-20. [PMID: 32757847 DOI: 10.1177/1971400920946635] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND The paranasal sinuses are complex anatomical structures, characterised by highly variable shape, morphology and size. With the introduction of multidetector scanners and the development of many post-processing possibilities, computed tomography became the gold standard technique to image the paranasal sinuses. Segmentation allows the extraction of metrical and shape data of these anatomical components that can be applied for diagnostic, education, surgical planning and simulation, and to plan minimally invasive interventions in otorhinolaryngology and neurosurgery. DISCUSSION Our aim was to provide a review of the existing literature on segmentation, its types and application, and the data obtained from this procedure. The literature search was conducted on PubMed (including Medline), ScienceDirect and Google Scholar databases, using the keywords as follows: 'paranasal sinuses', 'frontal sinus', 'maxillary sinus', 'sphenoid sinus', 'ethmoid sinus', in all possible combinations with the keywords 'segmentation' and 'volumetric analysis'. Inclusion criteria were: articles written in English, on living human subjects, on the adult population and focused on paranasal sinuses analysis. CONCLUSION This article provides an overview of the types and main application of segmentation procedures on paranasal sinuses, and the results provided by the studies on this topic.
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Affiliation(s)
| | - Daniele Gibelli
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Italy
| | - Annalisa Cappella
- Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Italy
| | - Tahereh Toluian
- Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Italy
| | - Carlo Valenti Pittino
- Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Italy
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A new classification proposal for sphenoid sinus pneumatization: a retrospective radio-anatomic study. Oral Radiol 2020; 37:118-124. [PMID: 32699975 DOI: 10.1007/s11282-020-00467-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The sphenoid sinus variations are very diverse and the frequency of these sinus variations is high. During operations involving the sphenoid sinus, such as pituitary surgeries, the surgeon should have detailed information about these variations. The aim of this study is to reclassify the sphenoid sinus pneumatizations in detail and to evaluate the incidence of pneumatization types in a Turkish population according to this classification. METHODS New classification proposal was made. In accordance with the proposed new classification, sphenoid sinus pneumatizations were evaluated on CBCT images. RESULTS When the posteroanterior pneumatization of 128 patients was evaluated; 2.3% conchal, 3.9% presellar, 35.9% sellar, and 57.8% postsellar pneumatization was detected. Of these cases, 28.9% had anterior pneumatization on the right and 23.4% on the left. When lateral direction pneumatizations were evaluated, lateral body type was found to be the most common on both right (44.1%) and left (42.5%) sides. CONCLUSION In this study, sphenoid sinus pneumatizations were evaluated three-dimensionally with the help of CBCT, and a new classification suggestion was made to eliminate the classification confusion we encountered in our previous studies. Pneumatizations and variations can affect the field of operation and even change planning. It should be taken into account that the paranasal sinuses may have variations due to their surgical importance and their close association with many vital structures.
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Intraoperative Sphenoid Sinus Volume Measurement as an Alternative Technique to Intraoperative Computer Tomography. Diagnostics (Basel) 2020; 10:diagnostics10060350. [PMID: 32481520 PMCID: PMC7344634 DOI: 10.3390/diagnostics10060350] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/24/2020] [Accepted: 05/26/2020] [Indexed: 11/17/2022] Open
Abstract
Isolated sphenoid sinus disease (ISSD) is where there is a group of pathologies characterized by inflammation in one or both sphenoid sinuses. Although computer tomography (CT)-based 3D reconstruction remains the gold standard among noninvasive approaches to ISSD diagnostics, no standardized techniques for direct intraoperative measurements of the sphenoid sinus volume in ISSD patients have been documented. We suggest a novel technique for the intraoperative measurement of the sphenoid sinus volume. Our technique is based on filling the sinus with 0.01% methylene blue solution after an endoscopic endonasal sphenoidotomy. The proposed technique was applied to 40 ISSD patients during surgery. Obtained intraoperative measurements were compared to noninvasive measurements from 3D reconstructions based on preoperative CT scans. Our results demonstrated that the obtained measurements did not exhibit significant differences exceeding 0.4 cm3, with CT-scan-based measurements in 39 out of 40 cases (p < 10−6, Wilcoxon sign-rank nonparametric test), thus confirming the accuracy of the proposed technique. Disagreements between direct intraoperative and CT-based measurements in a single case have been attributed to the presence of remaining pathological masses in the sinus, which was further confirmed during the secondary check of the operated sinus. Accordingly, we suggest that the agreement between the CT-based and intraoperative volume measurements can be used as an indicator of the successful elimination of all pathological masses from the sinus without having to perform an adequate exposure of the entire sphenoid sinus to reduce intraoperative bleeding. The proposed technique is accurate and does not require the involvement of specialized intraoperative CT scanners and avoids additional radiation exposure for the patient during an additional postoperation CT scan to confirm the success of the surgery.
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Sphenoid sinuses: pneumatisation and anatomical variants-what the radiologist needs to know and report to avoid intraoperative complications. Surg Radiol Anat 2020; 42:1013-1024. [PMID: 32394118 DOI: 10.1007/s00276-020-02490-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 04/30/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Sphenoid sinuses are pneumatised structures, placed in the body of the sphenoid bone, with highly variable morphology. The strict relationships with vascular and nervous structures determine the importance of their anatomical variants in otorhinolaryngology and neurosurgery; a precise understanding of the complex anatomy and anatomic variations of these structures is pivotal for radiological diagnosis of paranasal sinuses pathology and for surgical planning, to avoid potential complications. Our aim is to describe the anatomical variants of sphenoid sinuses, and to help general radiologists and specialists in endoscopic surgery in becoming familiar with these sensitive anatomical structures. METHODS A literature search of PubMed and Embase (Elsevier) databases was performed using the keywords "sphenoid sinus" and "anatomy, "sphenoid sinus" and "anatomic variants", "sphenoid sinus", and "anatomic variations". RESULTS We described the anatomical variants of the sphenoid sinuses anatomy, according to their size, shape, degree of pneumatisation, protrusion of anatomical structures into their lumen, superimposition of ethmoid cells (Onodi cells), and presence of accessory septations CONCLUSION: The information provided by this study may help in the identification and description of the anatomical variations of the sphenoid sinuses and their relationship to neurovascular structures.
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Souadih K, Belaid A, Ben Salem D, Conze PH. Automatic forensic identification using 3D sphenoid sinus segmentation and deep characterization. Med Biol Eng Comput 2019; 58:291-306. [PMID: 31848978 DOI: 10.1007/s11517-019-02050-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 09/18/2019] [Indexed: 11/28/2022]
Abstract
Recent clinical research studies in forensic identification have highlighted the interest in sphenoid sinus anatomical characterization. Their pneumatization, well known as extremely variable in degrees and directions, could contribute to the radiologic identification, especially if dental records, fingerPrints, or DNA samples are not available. In this paper, we present a new approach for automatic person identification based on sphenoid sinus features extracted from computed tomography (CT) images of the skull. First, we present a new approach for fully automatic 3D reconstruction of the sphenoid hemisinuses which combines the fuzzy c-means method and mathematical morphology operations to detect and segment the object of interest. Second, deep shape features are extracted from both hemisinuses using a dilated residual version of a stacked convolutional auto-encoder. The obtained binary segmentation masks are thus hierarchically mapped into a compact and low-dimensional space preserving their semantic similarity. We finally employ the ℓ2 distance to recognize the sphenoid sinus and therefore identify the person. This novel sphenoid sinus recognition method obtained 100% of identification accuracy when applied on a dataset composed of 85 CT scans stemming from 72 individuals. Automatic Forensic Identification using 3D Sphenoid Sinus Segmentation and Deep Characterization from Dilated Residual Auto-Encoders.
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Affiliation(s)
- Kamal Souadih
- Medical Computing Laboratory (LIMED), University of Abderrahmane Mira, 06000, Bejaia, Algeria.
| | - Ahror Belaid
- Medical Computing Laboratory (LIMED), University of Abderrahmane Mira, 06000, Bejaia, Algeria
| | - Douraied Ben Salem
- Laboratory of Medical Information Processing (LaTIM), UMR 1101, Inserm, 22 avenue Camille Desmoulins, 29238, Brest, France.,Neuroradiology Department, CHRU la cavale blanche, Boulevard Tanguy Prigent, UBO, 29609, Brest, France
| | - Pierre-Henri Conze
- Laboratory of Medical Information Processing (LaTIM), UMR 1101, Inserm, 22 avenue Camille Desmoulins, 29238, Brest, France.,IMT Atlantique, Technopôle Brest Iroise, 29238, Brest, France
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Morphometric Analysis of Sphenoid Sinus in Patients With Nasal Septum Deviation. J Craniofac Surg 2019; 30:1605-1608. [PMID: 31299779 DOI: 10.1097/scs.0000000000005443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This retrospective study aimed to assess the association of the volume and types of the sphenoid sinus with deviated nasal septum by analyzing multislice computed tomography images. A total of 93 patients with a deviated nasal septum and 70 healthy controls were included in the study. Patients with sinonasal morbidities other than deviation were excluded. Three-dimensionally reconstructed computed tomography images of the study participants were acquired. A total of 326 sphenoid sinus volumes from the patient and control groups were obtained and compared between the groups. Sphenoid sinus volumes and the angle of the deviation were measured for standardization and assessment of the severity. Deviated nasal septum was found on the right in 49.5% (n = 46) and on the left in 50.5% (n = 47) of the study participants. Deviation angles were in the range from 7.2° to 22.4° and the mean value was 13.2° ± 5.0°. The measured volumes were in the range from 1.8 cm to 9.6 cm with a mean of 4.8 ± 1.5 cm. In the control group, the median values for the sphenoid sinus volumes were 4.40 cm (0.80-8.90 cm) on the right and 4.20 cm (0.90-8.70 cm) on the left. In the study group, sphenoid sinus volumes were found to be statistically significantly different between those on the ipsilateral and contralateral side of the septal deviation. Sphenoid sinus volumes were significantly smaller on the same side with septal deviation compared with those on the contralateral side. There was no statistical relationship between the presence of septal deviation, age and gender, and the type of sphenoid sinus.
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Gomes AF, Brasil DM, Silva AIV, Freitas DQ, Haiter-Neto F, Groppo FC. Accuracy of ITK-SNAP software for 3D analysis of a non-regular topography structure. Oral Radiol 2019; 36:183-189. [PMID: 31267257 DOI: 10.1007/s11282-019-00397-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 06/27/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the accuracy of ITK-SNAP software for measuring volumes of a non-regular shape structure, using cone beam computed tomography (CBCT) scans, besides for developing a mathematical model to correct the software measurement error in case it existed. METHODS A phantom made by moulding a rubber duck's head was filled with total (38,000 mm3) and partial volumes of water (7000 mm3, 14,000 mm3, 21,000 mm3, 28,000 mm3 and 35,000 mm3), which constituted the gold standards. The sound phantom and the phantom filled with different volumes of water were scanned in a Picasso Trio CBCT unit set at 80 kVp, 3.7 mA, 0.2 mm3 voxel and 12 × 8.5 cm field of view. Semi-automatic segmentation was performed with ITK-SNAP 3.0 software by two trained oral radiologists. Linear regression analyzed the relation between ITK-SNAP calculated volumes and the gold standard. Intraclass correlation coefficient was applied to analyze the reproducibility of the method. Significance level was set at 5%. RESULTS Linear regression analysis showed a significant relationship between ITK-SNAP volumes and the gold standard (F = 22,537.3, p < 0.0001), with an R2 of 0.9993. The average error found was 4.7 (± 4.3) %. To minimize this error, a mathematical model was developed and provided a reduction of it. ICC revealed excellent intra-examiner agreements for both examiners 1 (ICC = 0.9991, p < 0.0001) and 2 (ICC = 0.9989, p < 0.0001). Likewise, inter-examiner agreement was excellent (ICC = 0.9991, p < 0.0001). CONCLUSION The software showed to be accurate for evaluating non-regular shape structures. The mathematical model developed reduced an already small error on the software's measurements.
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Affiliation(s)
- Amanda Farias Gomes
- Department of Oral Diagnosis-Oral Radiology, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, 13414-903, SP, Brazil
| | - Danieli Moura Brasil
- Department of Oral Diagnosis-Oral Radiology, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, 13414-903, SP, Brazil.
| | - Amaro Ilídio Vespasiano Silva
- Department of Oral Radiology, School of Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis-Oral Radiology, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, 13414-903, SP, Brazil
| | - Francisco Haiter-Neto
- Department of Oral Diagnosis-Oral Radiology, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901, Piracicaba, 13414-903, SP, Brazil
| | - Francisco Carlos Groppo
- Department of Physiological Sciences-Pharmacology, Anesthesiology and Therapeutics, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil
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29
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Wanzeler AMV, Alves-Júnior SM, Ayres L, da Costa Prestes MC, Gomes JT, Tuji FM. Sex estimation using paranasal sinus discriminant analysis: a new approach via cone beam computerized tomography volume analysis. Int J Legal Med 2019; 133:1977-1984. [PMID: 31236677 DOI: 10.1007/s00414-019-02100-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 05/27/2019] [Indexed: 12/01/2022]
Abstract
Sex estimation is an important step for subject identification in forensic medicine, to which paranasal sinuses may contribute, as they remain intact even upon severe damage to the skull and other bones. Cone beam computerized tomography (CBCT) is an excellent tool in the examination of these structures. The present study aimed to evaluate the maxillary, frontal and sphenoidal sinuses through a discriminant analysis to determine the sex correlations with foramen magnum measurements were also assessed. Two-hundred cranial CBCT scans were analysed. The volume of the maxillary, frontal and sphenoidal sinuses were measured using the ITK-SNAP software (4.0.2). Student's t test and the Mann-Whitney test were applied for the descriptive analysis of independent samples, and data were subjected to discriminant analysis. The volumes of the maxillary, frontal and sphenoidal sinuses of female subjects were smaller than those of male subjects (p < 0.001). Upon summing up the volumes of the evaluated paranasal sinuses, the chances to correctly determine an individual's gender are 96.2% and 92.7% for males and females, respectively. When correlating said values with foramen magnum measurements, sex identification chances increase to 100%. Thus, adult paranasal sinus volumes analysed by CBCT may be useful for sex identification when summed together and correlated with foramen magnum measurements.
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Affiliation(s)
- Ana Márcia Viana Wanzeler
- Department of Odontology, Federal University of Pará, Belem, Pará, Brazil. .,Institute of Health Sciences, School of Dentistry, Federal University of Para - UFPA, Avenida Augusto Correa, 01, Belem, PA, 66075-110, Brazil.
| | | | - Lucas Ayres
- Departament of Statistics, Federal University of Minas Gerais, Belo Horizonte, Brazil
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30
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Costa ALF, Paixão AK, Gonçalves BC, Ogawa CM, Martinelli T, Maeda FA, Trivino T, Lopes SLPDC. Cone Beam Computed Tomography-Based Anatomical Assessment of the Olfactory Fossa. Int J Dent 2019; 2019:4134260. [PMID: 31073308 PMCID: PMC6470455 DOI: 10.1155/2019/4134260] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/15/2019] [Accepted: 03/13/2019] [Indexed: 12/04/2022] Open
Abstract
This study aimed to investigate the olfactory fossa according to the Keros classification using cone beam computed tomography. This cross-sectional study analysed cone beam computed tomography images selected from a database belonging to a radiology centre. The scans of 174 healthy patients were analysed by using the Xoran software. Gender, age, and side were correlated with the Keros classification. The mean age of the 174 patients was 45.3 years. The most prevalent Keros classification was type II (65.52%), followed by type III (20.69%) and type I (13.79%). No significant differences were found between Keros classification and the variables age, right side (p value = 0.4620), and left side (p value = 0.5709). There were also no significant differences between gender and the variables right side (p value = 0.1421) and left side (p value = 0.2136). Based on these results, we suggest that cone beam computed tomography can be recommended for analysis of the anterior skull base. Keros type II was the most prevalent type in our sample.
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Affiliation(s)
| | - Aline Kataki Paixão
- Department of Diagnosis and Surgery, São José dos Campos Dental School, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
| | - Bianca Costa Gonçalves
- Department of Diagnosis and Surgery, São José dos Campos Dental School, São Paulo State University (UNESP), São José dos Campos, SP, Brazil
| | - Celso Massahiro Ogawa
- Postgraduate Program in Dentistry, Cruzeiro do Sul University (UNICSUL), São Paulo, SP, Brazil
| | - Thiago Martinelli
- Department of Orthodontics and Radiology, University of São Paulo City (UNICID), São Paulo, SP, Brazil
| | - Fernando Akio Maeda
- Department of Orthodontics and Radiology, University of São Paulo City (UNICID), São Paulo, SP, Brazil
| | - Tarcila Trivino
- Department of Orthodontics and Radiology, University of São Paulo City (UNICID), São Paulo, SP, Brazil
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Nejaim Y, Farias Gomes A, Valadares CV, Costa ED, Peroni LV, Groppo FC, Haiter-Neto F. Evaluation of volume of the sphenoid sinus according to sex, facial type, skeletal class, and presence of a septum: a cone-beam computed tomographic study. Br J Oral Maxillofac Surg 2019; 57:336-340. [PMID: 30930032 DOI: 10.1016/j.bjoms.2018.12.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 12/26/2018] [Indexed: 10/27/2022]
Abstract
We have used cone-beam computed tomographic (CT) images to retrospectivelyevaluate the influence of sex, skeletal class, facial type, and the presence of septa on the volume of the sphenoid sinus in 172 images from 85 men (mean (SD) age 28 (2) years) and 87 women (mean (SD) age 30 (1) years). Skeletal class and facial type were calculated for each patient from multiplanar reconstructions using NemoCeph® software. Volumetric analysis of the sphenoid sinus was made with the help of the ITK-SNAP® 3.4.0 segmentation software, while the presence or absence of septa in the sphenoid sinus was evaluated with the Carestream 3D Imaging® software 3.4.3. We analysed the results using two-way ANOVA, Student's independent sample t test, and Fisher's exact test, as appropriate, and probabilities of <0.05 were accepted as significant. Sex (p=0.0946), facial type (p=0.790), and skeletal class (p=0.120) had no significant influence on the volume of the sphenoid sinus, and nor did the volumes of the right and left sphenoid sinuses (p=0.0923), or the presence of a septum within the sinus (p=0.330) in its volume.
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Affiliation(s)
- Y Nejaim
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901 - Areião, Piracicaba, SP 13414-903, Brazil.
| | - A Farias Gomes
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901 - Areião, Piracicaba, SP 13414-903, Brazil
| | - C V Valadares
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901 - Areião, Piracicaba, SP 13414-903, Brazil
| | - E D Costa
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901 - Areião, Piracicaba, SP 13414-903, Brazil
| | - L V Peroni
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901 - Areião, Piracicaba, SP 13414-903, Brazil
| | - F C Groppo
- Department of Physiological Sciences, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901 - Areião, Piracicaba, SP 13414-903, Brazil
| | - F Haiter-Neto
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Av. Limeira, 901 - Areião, Piracicaba, SP 13414-903, Brazil
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Abstract
The sphenoid sinus is located in the center of the cranial base and is surrounded by numerous neurovascular structures. The aim of this study was to determine sphenoid sinus types and subtypes, dimensions of the sinus and cranium, and the relations of these to age and gender.Computed tomography data was obtained from 144 patients to determine right sphenoidal volume (sphVOLR), left sphenoidal volume (sphVOLL), total sphenoidal volume (sphVOLT), anteroposterior length of the sphenoid sinus (sphAP), laterolateral length of the sphenoid sinus (sphLL), head circumference (crHC), fronto-occipital length (crFO), and biparietal length (crBP), with OSIRIX software. The patients' ages ranged between 9 and 83 years (mean age 38 ± 15.5 years). The study included 89 males (mean age 39 ± 15.5 years) and 55 females (mean age 38 ± 15.6 years).Conchal (1.4%), presellar (8.3%), sellar (23.6%), and postsellar (66.7%) type sphenoid sinuses were determined based on the extension of pneumatization around the sella turcica. Each type of sphenoid sinus was classified into the following 5 types based on the direction of pneumatization: body, full lateral, pterygoid, lesser wing, and greater wing subtypes. Mean sphAP was determined as 29.72 mm and mean sphLL as 37.73 mm. In 5 patients only (3.4%), the sphenoid sinus was not divided into right and left by the intersphenoidal septum.The variations in the extensions of pneumatization of the sphenoid sinus and its dimensions might be used to estimate the selection of a surgical approach to lesions bordering the sinus.
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Vlaški A, Erić M, Sotirović-Seničar S. Anatomical variations of sphenoid sinus pneumatisation in Vojvodina's population. MEDICINSKI PODMLADAK 2019. [DOI: 10.5937/mp70-22181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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3D Reconstruction and Prediction of Sialolith Surgery. Case Rep Dent 2018; 2018:3951956. [PMID: 30538868 PMCID: PMC6257896 DOI: 10.1155/2018/3951956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 07/29/2018] [Accepted: 08/28/2018] [Indexed: 11/17/2022] Open
Abstract
Imaging examinations play an important role in the diagnosis of sialolithiasis, whose symptoms are initially confounded with other diseases. The objective of the present case report is to highlight imaging and processing techniques as well as image analysis for the preoperative assessment and planning of surgical interventions and adequate treatment of massive sialoliths. A 35-year-old male patient presented complaining of pain in the submandibular region and purulent secretions from a lingual caruncle with slightly increased volume in the region. Imaging examinations were ordered as follows: cone beam computed tomography, ultrasonography, and three-dimensional reconstruction, including clinical evaluation. A final diagnosis of sialolithiasis was established. Surgery was indicated and carried out by using a lateral transcervical approach for complete resection of the gland, which was based on the calculation of the total volume of the sialolith, thus increasing the surgery's success.
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35
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Gomes JPP, Veloso JDRC, Altemani AMDAM, Chone CT, Altemani JMC, de Freitas CF, Lima CSP, Braz-Silva PH, Costa ALF. Three-Dimensional Volume Imaging to Increase the Accuracy of Surgical Management in a Case of Recurrent Chordoma of the Clivus. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:1168-1174. [PMID: 30275439 PMCID: PMC6180943 DOI: 10.12659/ajcr.911592] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Patient: Male, 53 Final Diagnosis: Clivus chordoma Symptoms: Pain the eye Medication: — Clinical Procedure: — Specialty: Radiology
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Affiliation(s)
- João Pedro Perez Gomes
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of Sao Paulo (USP), São Paulo, SP, Brazil
| | - José de Ribamar Castro Veloso
- Department of Orthodontics and Radiology, School of Dentistry, University City of São Paulo (UNICID), São Paulo, SP, Brazil
| | | | - Carlos Takahiro Chone
- Department of Ophthalmology and Otorhinolaryngology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | | | - Claudio Fróes de Freitas
- Department of Orthodontics and Radiology, School of Dentistry, University City of São Paulo (UNICID), São Paulo, SP, Brazil
| | - Carmen Silvia Passos Lima
- Department of Internal Medicine, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, SP, Brazil
| | - Paulo Henrique Braz-Silva
- Division of General Pathology, Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, SP, Brazil
| | - Andre Luiz Ferreira Costa
- Department of Orthodontics and Radiology, School of Dentistry, University City of São Paulo (UNICID), São Paulo, SP, Brazil
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Volumetric assessment of sphenoid sinuses through segmentation on CT scan. Surg Radiol Anat 2017; 40:193-198. [PMID: 29270712 DOI: 10.1007/s00276-017-1949-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 11/24/2017] [Indexed: 10/14/2022]
Abstract
PURPOSE Computed tomography represents the gold standard for the assessment of morphological characteristics of sphenoid sinuses, whose anatomy has acquired a novel interest because of the recent introduction of transsphenoidal surgery and robot-assisted procedures. One of the most relevant parameters for planning surgical intervention is the volume of sphenoid sinuses, and with time few population studies have been published. However, at present, no data are available concerning the relation between volume and anatomical variants of sphenoid sinuses. METHODS We retrospectively evaluated head CT-scans of 100 patients (age range 25-99 years; mean age males 45.0; mean age females 50.5 years) to calculate the volume of sphenoid sinuses through automatic segmentation. Possible statistically significant differences according to sex and variants of pneumatization, and type of sinus were assessed, respectively, through Student's t test and one-way ANOVA test (p < 0.05). RESULTS Average volume of sphenoid sinuses in males was 10.005 ± 5.101 cm3, in females 7.920 ± 3.176 cm3. Differences according to sex were statistically significant (p < 0.05). Patients with pneumatization of pterygoid processes, dorsum sellae and anterior clinoid processes had a significantly higher volume than unaffected subjects. Moreover, differences of volume according to the type of sphenoid sinus were statistically significant (p < 0.05). CONCLUSIONS Results show that volume of sphenoid sinuses strongly depend upon the type of sinus and possible pneumatization variants. Moreover, the important of ethnic variability is confirmed.
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Senturk M, Guler I, Azgin I, Sakarya EU, Ocal R, Agirgol B, Alatas N, Tolu I, Kilinc M. Sphenoethmoid Cell: The Battle for Places Inside of the Nose Between a Posterior Ethmoid Cell and Sphenoid Sinus: 3D-Volumetric Quantification. Curr Med Imaging 2017; 13:478-483. [PMID: 29249918 PMCID: PMC5709517 DOI: 10.2174/1573405613666170126150024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 01/13/2017] [Accepted: 01/17/2017] [Indexed: 12/23/2022]
Abstract
Background Sphenoethmoid cells may be above the sphenoid sinus with/ or without con-tact to optical nerve. Although sphenoethmoid cells are theoretically considered to possibly influence the sphenoid sinus volume, we could not find any study in the literature on this issue. Aims The aim of our study was to detect sphenoethmoid cells and measure the sphenoid sinus vol-ume using multiplanar computerized tomography and also investigate the correlation between the presence of sphenoethmoid cells and the sphenoid sinus volume. Methods Retrospectively 141 patients who had available paranasal computerized tomography images were included in this study. The sphenoid sinus volumes of each patient were calculated individually for each side, and the relationship between the presence of sphenoethmoid cell and sphenoid sinus volume was investigated. Results Sphenoethmoid cells were detected at 106 (37.5%) of the total 282 sides in 141 patients. No gender difference was observed. The total sphenoid sinus volume was significantly lower in the group of patients who had bilateral sphenoethmoid cells than in the sphenoethmoid cell negative group. In patients with a unilateral sphenoethmoid cell, a significant decrease in the sphenoid sinus volume was observed only for the side where the sphenoethmoid cell was located. Conclusion It was observed that the sphenoethmoid cells caused a significant reduction in the sphe-noid sinus volume on the side where they were located. In the case of low sphenoid sinus aeration, the sphenoethmoid cell should be kept in mind. Further studies with an extended patient series are required to explore this issue.
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Affiliation(s)
- Mehmet Senturk
- Department of Otolaryngology Head and Neck Surgery, Konya Training and Research Hospital, Konya, Turkey
| | - Ibrahim Guler
- Department of Radiology, Medical Faculty, Selçuk University, Konya, Turkey
| | - Isa Azgin
- Department of Otolaryngology Head and Neck Surgery, Konya Training and Research Hospital, Konya, Turkey
| | - Engin Umut Sakarya
- Department of Otolaryngology Head and Neck Surgery, Konya Training and Research Hospital, Konya, Turkey
| | - Ramazan Ocal
- Department of Otolaryngology Head and Neck Surgery, Konya Training and Research Hospital, Konya, Turkey
| | - Betul Agirgol
- Department of Otolaryngology Head and Neck Surgery, Konya Training and Research Hospital, Konya, Turkey
| | - Necat Alatas
- Department of Otolaryngology Head and Neck Surgery, Konya Training and Research Hospital, Konya, Turkey
| | - Ismet Tolu
- Department of Radiology, Konya Training and Research Hospital, Konya, Turkey
| | - Mehmet Kilinc
- Department of Otolaryngology Head and Neck Surgery, Konya Training and Research Hospital, Konya, Turkey
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Three-dimensional volumetric analysis of ghost cell odontogenic carcinoma using 3-D reconstruction software: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol 2017; 123:e170-e175. [PMID: 28407991 DOI: 10.1016/j.oooo.2017.01.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 12/21/2016] [Accepted: 01/21/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Ghost cell odontogenic carcinoma is a very rare malignant neoplasm. Tumor volume may be a more precise alternative for determining size, which is usually measured by maximum linear dimension. The purpose of this case report is to highlight the importance of obtaining 3-dimensional (3-D) images of the tumor for volumetric analysis to improve the chances of surgical success. This report presents a case of ghost cell odontogenic carcinoma infiltrating the maxillary sinus through the palate. The lesion was surgically treated and subsequently selected for volumetric reconstruction and analysis of the tumor by using InVesalius software. In this case report, we describe the use of a pictorial technique in which the tumor volume was calculated to help predict the surgical results. RESULTS The tumor could be visualized in 3-D, with color improving the image of the segmented volume and thus increasing the perception of boundaries and depth. CONCLUSIONS Recognition of the lesion shape by volumetric analysis can provide the surgical team with clearer information, thereby helping in surgical planning and consequently increasing the chances of surgical success.
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