Pneumatization pattern of the sphenoid sinus on computed tomography as part of preoperative evaluation for transsphenoidal endoscopic surgery
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Abstract
Background: The determination of the pneumatization pattern of the Sphenoid Sinus (SS) and its relationship with neurovascular structures in the preoperative tomographic analysis provides a greater insight of the SS anatomy to minimize the potential intraoperative risk to vital structures. The objective of this study was to estimate the frequency of presentation of the different types of pneumatization of the SS, protrusion/dehiscence of the Internal Carotid Artery (ICA), intersinus septation and aberrant pneumatization in the evaluation of CT scan of paranasal sinuses in the Central Military Hospital from Bogota. Methods: A descriptive cross-sectional study. It reviewed 756 CT scans, randomly selecting 422 of these. The frequency of presentation of each type of pneumatization of the SS was estimated. The findings were analyzed with descriptive statistics. Results: The most frequent type of pneumatization using the Güldner et al. classification was the Postsellar IVa, followed by the Sellar and Postsellar IVb. The protrusion of the ICA and its dehiscence were both more commonly present in the more extensive types of pneumatization of the SS, as well as “aberrant” pneumatization patterns. The multiple septation pattern predominated in 86.3% of the cases. Conclusion: The analysis of preoperative tomography for transsphenoidal endoscopic surgery is essential to recognize the type of pneumatization of the SS and its variants, which allows minimizing the risk of injuring vital structures. The greater extent of pneumatization is related to a greater frequency of risk variants of ICA; these types of more extensive pneumatization predominated in this study.
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