Pneumatization of Mastoid Air Cells, Temporal Bone, Ethmoid and Sphenoid Sinuses. Any Correlation?

Abstract

The aim of this study is to assess the pneumatization of the paranasal sinuses (PNS) and other parts of temporal bone such as mastoid air cells and to investigate if there was any association between the aeration of these structures among the three major ethnic groups in Malaysia (Malay, Chinese, Indian) as this would be representative of Asia. A retrospective review of 150 computed tomography (CT) scans of PNS and temporal bones was done and analysed. The pneumatization of each area was obtained and compared using statistical analysis. Patients with a history of previous medical or surgical problems in the intended areas were excluded from the study. The pneumatization of the mastoid air cells and other temporal bone parts were noted to be symmetrical in more than 75 %. There was a positive correlation between the pneumatization of mastoid air cells and that of the sphenoid sinus. The prevalence of Agger nasi, Haller's and Onodi cells was observed to be significantly higher in the Chinese group. Preoperative assessment of the temporal bone and PNS with CT scan may be helpful in the evaluation of their anatomical landmark and decrease the possibility of surgical complications related to 3D structures.

Keywords: Ethmoid; Mastoid; Pneumatization; Sinuses; Sphenoid.

Fig. 1

Axial view of the temporal bone showing: a well pneumatised mastoid regions, b poorly pneumatised mastoid air cell, c none pneumatised mastoids (sclerotic type)

Fig. 2

a Presellar type of sphenoid sinus, b postsellar sphenoid sinus in which the pneumatization extends back beneath the pituitary fossa

Fig. 3

Multiplanar view of the CT scan demonstrating Agger nasi cell on the right side

Fig. 4

Multiplanar view of the CT scan demonstrating Haller cell on the left side

Fig. 5

Coronal CT scan image showing bilaterally pneumatized middle turbinate (concha bullosa)

Fig. 6

Multiplanar view of CT scan demonstrating Onodi cell (right side)

Fig. 7

Coronal CT scan image showing pneumatized crista galli

Graph 1

Histogram showing the correlation between pneumatization of the mastoid and other temporal bone parts (perilabyrinthine and petrous apex) in all races