Variations of sphenoid pneumatization: a CBCT study

Open access


BACKGROUND. The pneumatization pattern of the sphenoid sinus seems rather unpredictable, as resulted from previous studies. It is however extremely important for endoscopic approaches to target structures of the middle cranial fossa, such as the pituitary gland.

MATERIAL AND METHODS. We aimed at documenting by Cone Beam Computed Tomography (CBCT) the possibilities of anatomic variation of the sphenoid sinus. 25 randomly selected patients were retrospectively analyzed.

RESULTS. In 56%, the left and right sphenoidal sinuses were bilaterally symmetrical with respect to the sagittal pneumatization type: four patients had sellar types, one had presellar type and in nine cases the sphenoidal sinuses were reaching posteriorly to the sella turcica. Only in 8% of cases were found conchal types of pneumatization, but they were part of anatomical pictures including Onodi air cells. Such an Onodi cell presented a posterior (sphenoidal) recess reaching posteriorly and superiorly to the pterygopalatine fossa. The recesses of the sphenoid sinus were also documented: anterior or septal, ethmoidal, maxillary, clinoidal and lateral. In 32% was found a lateral recess only engaged between the vidian and maxillary nerve canals.

CONCLUSION. It appears that CBCT is a reliable tool for accurate anatomic identification of the sphenoid sinus pneumatization pattern, on a case-by-case basis.

If the inline PDF is not rendering correctly, you can download the PDF file here.

  • 1. Wang J. Bidari S. Inoue K. Yang H. Rhoton A. Jr. - Extensions of the sphenoid sinus: a new classification. Neurosurgery 2010;66:797-816.

  • 2. Unlu A. Meco C. Ugur H.C. Comert A. Ozdemir M. Elhan A. - Endoscopic anatomy of sphenoid sinus for pituitary surgery. Clin Anat. 2008;21:627-632.

  • 3. Varshney S. Gupta C. Bansal K.K. Bist S.S. Bhagat S. - Endoscopic Trans-Nasal Trans-Sphenoidal (TNTS) Approach For Pituitary Adenomas: Our Experience. Indian J Otolaryngol Head Neck Surg. 2013;65:308-313.

  • 4. Sapci T. Derin E. Almac S. Cumali R. Saydam B. Karavus M. - The relationship between the sphenoid and the posterior ethmoid sinuses and the optic nerves in Turkish patients. Rhinology 2004;42:30-34.

  • 5. Terra E.R. Guedes F.R. Manzi F.R. Boscolo F.N. - Pneumatization of the sphenoid sinus. Dento Maxillo Facial Radiology 2006;35:47-49.

  • 6. Citardi M.J. Gallivan R.P. Batra P.S. Maurer C.R. Jr. Rohlfing T. Roh H.J. Lanza D.C. - Quantitative computer-aided computed tomography analysis of sphenoid sinus anatomical relationships. American Journal of Rhinology 2004;18:173-178.

  • 7. Tan H.K. Ong Y.K. - Sphenoid sinus: an anatomic and endoscopic study in Asian cadavers. Clin Anat. 2007;20:745-750.

  • 8. Congdon E. - The distribution and mode of origin of septa and walls of the sphenoid sinus. Anat Rec (Hoboken) 1920;18:97-123.

  • 9. Tomovic S. Esmaeili A. Chan N.J. Shukla P.A. Choudhry O.J. Liu J.K. Eloy J.A. - High-resolution computed tomography analysis of variations of the sphenoid sinus. Journal of Neurological Surgery Part B Skull base 2013;74:82-90.

  • 10. Wiebracht N.D. Zimmer L.A. - Complex anatomy of the sphenoid sinus: a radiographic study and literature review. Journal of Neurological Surgery Part B Skull base 2014;75:378-382.

  • 11. Rusu M.C. Didilescu A.C. Jianu A.M. Paduraru D. - 3D CBCT anatomy of the pterygopalatine fossa. Surgical and Radiologic Anatomy: SRA 2013;35:143-159.

  • 12. Anusha B. Baharudin A. Philip R. Harvinder S. Shaffie B.M. - Anatomical variations of the sphenoid sinus and its adjacent structures: a review of existing literature. Surgical and Radiologic Anatomy: SRA 2014;36:419-427.

  • 13. Guldner C. Pistorius S.M. Diogo I. Bien S. Sesterhenn A. Werner J.A. - Analysis of pneumatization and neurovascular structures of the sphenoid sinus using cone-beam tomography (CBT). Acta Radiol. 2012;53:214-219.

  • 14. Lang J. - Clinical anatomy of the nose nasal cavity and paranasal sinuses. Thieme 1989.

  • 15. Ciobanu I.C. Motoc A. Jianu A.M. Cergan R. Banu M.A. Rusu M.C. - The maxillary recess of the sphenoid sinus. Rom J Morphol Embryo. 2009;50:487-489.

  • 16. Jianu A.M. Rusu M. Vrapciu A.D. Sandulescu M. - Hyperpneumatized skull bones. Revista Romana de Anatomie functionala si clinica macro- si microscopica si de Antropologie 2014;13(1).

  • 17. Andrei F. Motoc A.G. Jianu A.M. Rusu M.C. Loreto C. - The pneumatization patterns of the roof of the parapharyngeal space in CBCT. Germs 2012;2:142-147.

  • 18. Tami T.A. - Surgical management of lesions of the sphenoid lateral recess. American Journal of Rhinology 2006;20:412-416.

  • 19. Ozturan O. Yenigun A. Degirmenci N. Aksoy F. Veyseller B. - Coexistence of the Onodi cell with the variation of perisphenoidal structures. Eur Arch Otorhinolaryngol. 2013;270:2057-2063.

  • 20. Hwang S.H. Joo Y.H. Seo J.H. Cho J.H. Kang J.M. - Analysis of sphenoid sinus in the operative plane of endoscopic transsphenoidal surgery using computed tomography. Eur Arch Otorhinolaryngol. 2014;271:2219-2225.

  • 21. Xiao S.X. Ma Y.H. Zhan R.Y. Wen L. - Sella turcica anatomy by threedimensional computed tomography for an endonasal transsphenoidal approach to pituitary adenoma. Minimally Invasive Neurosurgery: MIN 2011;54:162-166.

  • 22. Stuehmer C. Essig H. Bormann K.H. Majdani O. Gellrich N.C. Rucker M. - Cone beam CT imaging of airgun injuries to the craniomaxillofacial region. Int J Oral Maxillofac Surg. 2008;37:903-906.

  • 23. Jalali E. Tadinada A. - Arrested pneumatization of the sphenoid sinus mimicking intraosseous lesions of the skull base. Imaging Science in Dentistry 2015;45:67-72.

Journal information
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 310 118 7
PDF Downloads 139 77 9