Cone Beam Computed Tomography Analysis of Sphenoid Sinus Pneumatization and Relationship with Neurovascular Structures

Evaluation of the relationship between sphenoid sinus morphology and area and volume by computed tomography

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.

Sphenoid Sinus Pneumatization Types and Correlation with Adjacent Neurovascular Structures Using Cone-Beam Computed Tomography

Aims: This study aimed to assess the sphenoid sinus pneumatization types and their correlation with adjacent neurovascular structures using cone-beam computed tomography (CBCT). Materials and methods: This cross-sectional study was conducted on 97 CBCT scans of patients over 18 years of age that were retrieved from the archives of the Oral & Maxillofacial Radiology Department of School of Dentistry. Type of sphenoid sinus pneumatization based on its relationship with sella turcica (conchal, presellar, sellar, and postsellar), the correlation of internal carotid artery (ICA) and optic nerve (ON) with the sinus cavity in the axial and coronal planes (smooth or prolonged type), and presence of Onodi cells and their correlation with the sphenoid sinus (lateral, superior, and superolateral) were all evaluated on CBCT sections. Data were analyzed by the Chi-square and Fisher's exact tests (alpha = 0.05). Results: Postsellar type was the most common sphenoid sinus pneumatization type (82.5%). The Smooth type was the most common form of correlation of ON and ICA with the sphenoid sinus. Onodi cells were noted in 28.9% of the cases; among which, the lateral type had the highest prevalence. Conclusion: Considering the high prevalence of sphenoid sinus pneumatization, Onodi cells, and ON and ICA protrusion in our study population, CBCT should be requested prior to trans-sphenoidal surgical procedures to prevent perioperative and postoperative complications.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12070-023-03796-0.