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. 2021 Mar;20(1):105-114.
doi: 10.1007/s12663-020-01326-x. Epub 2020 Jan 14.

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

Najmeh Movahhedian  1 , Maryam Paknahad  2 , Fatemeh Abbasinia  3 , Leila Khojatepour  1
Affiliations

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

Najmeh Movahhedian et al. J Maxillofac Oral Surg. 2021 Mar.

Abstract

Background: The sphenoid sinus is considered as the most variable pneumatized structure of the skull.

Purpose: The aim of the present study was to determine the prevalence of the Onodi cell as well as to evaluate the relationship between the sphenoid sinus type of pneumatization and the presence of surrounding neurovascular protrusion using cone beam computed tomography (CBCT).

Methods: The CBCT images of 500 patients/996 sides [203 males (40.6%) and 297 females (59.4%)] were analyzed in this study. The type of sphenoid sinus pneumatization, prevalence of internal carotid artery (ICA) and optic nerve (ON) protrusion and dehiscence, and also the frequency of Onodi cell were assessed.

Results: The percentages of the conchal, presellar, sellar, postsellar (a), and postsellar (b) types of pneumatization were 1%, 11.5%, 35.5%, 38.9%, and 13.1%, respectively. The more the sphenoid sinuses pneumatized, the greater the frequency of ON and ICA protrusion and dehiscence of their wall to the sinus. The prevalence of Onodi cell was 38.8%. A significant correlation was found between ON dehiscence and the presence of Onodi cells.

Conclusion: The present study demonstrated a significant relationship between the sinus type and frequency of neurovascular protrusions. Therefore, the sphenoid sinus extent of pneumatization might be useful in predicting the risk of iatrogenic damage to the surrounding structures.

Keywords: Cone beam computed tomography; Internal carotid artery; Optic nerve; Pneumatization; Sphenoid sinus.

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Conflict of interest statement

Conflict of interestAll authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Different types of sphenoid sinus pneumatization: a conchal (type I); b presellar (type II); c sellar (type III); d postsellar without posterior clinoid process involvement (type IVa); e postsellar with air cells in posterior clinoid process (type IVb)
Fig. 2
Fig. 2
Optic nerve protrusion into sphenoid sinus cavity: smooth type in a irrelevant (in right side) and touching (in left side)types; and prolonged type in b with protrusion less than 50% (in the left side); and c with protrusion greater than 50%
Fig. 3
Fig. 3
Internal carotid artery protrusion into the sphenoid sinus cavity: smooth type in a irrelevant and b touch; and prolonged type in c with less than 50% protrusion and d with greater than 50% protrusion
Fig. 4
Fig. 4
Different types of Onodi cell: superior type in a coronal and b sagittal planes; c superolateral type; lateral type in d coronal and e axial planes
See this image and copyright information in PMC

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