Crista galli sinusitis – a radiological impression or a real clinical entity

BACKGROUND. Crista galli is an anatomical structure localized in the midline, that derives from the ethmoid bone, with a compact bone structure, sometimes pneumatized. The connection between the pneumatized crista galli and the adjacent paranasal structures is usually performed through an opening similar with a sinusal ostium.

MATERIAL AND METHODS. We performed a retrospective clinical study about the incidence of the pneumatization of crista galli in 196 patients with chronic sinusitis. We evaluated the degree of pneumatization and the drainage pathways of crista galli, trying to correlate the radiological findings with the symptomatology of the patients with crista galli “sinusitis”.

RESULTS. Pneumatization of crista galli was found in 30.1% of cases. From 59 patients with chronic rhinosinusitis and pneumatized crista galli, 66.4% had no opacification, 23.7% various degrees of opacification and 11.9% showed complete opacification. The presence of an opening of the pneumatized crista galli into surrounding air-cells was found in 16.98% of the patients. Headache was encountered in 76.2% of the patients with CRS and pneumatized crista galli sinusitis.

CONCLUSION. When analyzing a CT scan of a patient with CRS, we should also take into consideration the pneumatization of crista galli, which has a high variability. Most of the patients included in our study had also a certain degree of opacification of the pneumatized crista galli. Headache had a higher incidence in patients with crista galli inflammation than in CRS patients who showed no pneumatization or opacification of the crista galli (76.2% versus 60.5% in “simple” CRS patients).