Sapçi Tarik, Derin Esin, Almaç Senem, Cumali Rana, Saydam Bülent, Karavuş Melda
Department of Otorhinolaryngology-Head & Neck Surgery, PTT (Posta Telefon Telgraf) Training Hospital, Istanbul, Turkey.
Rhinology. 2004 Mar;42(1):30-4.
The sphenoid and the posterior ethmoid sinuses are surrounded by more vital structures than any other sinus. With the widespread acceptance and expanding role of endoscopic sinus surgery, a proper understanding of the anatomy of the sphenoid and the posterior ethmoid sinuses is achieved. We reviewed 100 CT studies of the paranasal sinuses belonging to patients examined for a chronic inflammatory disease of the nasal cavity and the paranasal sinuses. The relationship between the optic nerves and the paranasal sinuses is classified into four discrete categories. Type 1 with a proportion of 64% is observed to be the most often localized optic nerve. Type 2 is detected in 22% of the cases; types 3 and 4 are both 7% of the total number. A bony dehiscence was detected in 13.5% of the total cases, while it was observed in 39% of type 2 and 43% of type 3. We found a pneumatization of the anterior clinoid process in 11% of the patients. The proportion of pneumatization of the anterior clinoid process in type 3 configurations is found out to be as high as 86%. Optic nerve dehiscence was seen with a proportion of 23% in cases of pneumatization of the anterior clinoid process. Pneumatization of the posterior nasal septum was detected in 15% of the 100 cases. When the optic nerves were evaluated in these cases, mostly the type 1 configuration with a proportion of 63% was observed. An extensively pneumatized sphenoid sinus was detected in 4% of the 100 cases. Five of the investigated 8 optic nerves of these 4 cases were found out to be type 3 (62.5%). No significant optic nerve variations were met in patients with pneumatization of the posterior nasal septum. Nevertheless while performing surgery, it is important to bear in mind that there may be significant optic nerve variations with pneumatization of the anterior clinoid process and extensively pneumatized sphenoid sinuses.
蝶窦和后筛窦比其他任何鼻窦都被更多重要结构所环绕。随着鼻内镜鼻窦手术的广泛接受和作用不断扩大，人们对蝶窦和后筛窦的解剖结构有了恰当的认识。我们回顾了100例因鼻腔和鼻窦慢性炎症疾病接受检查的患者的鼻窦CT研究。视神经与鼻窦的关系分为四种不同类型。1型占比64%，是最常见的视神经定位类型。2型在22%的病例中被检测到；3型和4型均占总数的7%。在所有病例中，13.5%检测到骨质缺损，而在2型病例中为39%，3型病例中为43%。我们发现11%的患者存在前床突气化。在3型结构中，前床突气化的比例高达86%。在前床突气化的病例中，视神经缺损的比例为23%。在100例病例中，15%检测到后鼻中隔气化。在这些病例中评估视神经时，大多观察到1型结构，占比63%。在100例病例中，4%检测到蝶窦广泛气化。这4例中所研究的8条视神经中有5条为3型（62.5%）。后鼻中隔气化的患者未发现明显的视神经变异。然而，在进行手术时，重要的是要记住，前床突气化和蝶窦广泛气化可能会伴有明显的视神经变异。
