Anusha B, Baharudin A, Philip R, Harvinder S, Shaffie B Mohd, Ramiza R R
Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Kelantan, Malaysia.
Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Raja Permaisuri Bainun, 30990, Ipoh, Perak, Malaysia.
Surg Radiol Anat. 2015 Dec;37(10):1183-90. doi: 10.1007/s00276-015-1494-8. Epub 2015 May 20.
Failure of a surgeon to understand the local variations of the anatomical landmarks of the sphenoid sinus is a potential risk factor to cause damage to the optic nerve (ON) or internal carotid artery (ICA) that lies on the walls of the sphenoid sinus. The aim of this study was to identify the anatomical variants of the sphenoid sinus and its related surrounding structures among the Southeast Asian (SEA) population, based on computed tomography (CT) scans.
This cross-sectional study analyzed 300 CT scans of the brain, paranasal sinuses (PNS), and head and neck (H&N) at a tertiary referral centre in Malaysia utilizing the Osirix software. The images were reconstructed into 1 mm cuts on bone window. Demographic details and scan findings were documented in a standardized data collection sheet.
The rates of ON dehiscence, ICA dehiscence and ICA protrusion in the SEA population were 7.0, 3.0 and 10.0 %, respectively. The rate of ON protrusion was 2.3 %. There was no statistically significant relationship (p > 0.05) noted on Chi-square test, between anterior clinoid process (ACP) pneumatization and ON protrusion. The rate of Onodi cells in our population was 14.3 %. The average vertical distance of the ostia from the roof of the posterior choanae was 1.42 cm (±0.32). The horizontal distance of the ostia from the anterior end of the superior turbinate was 1.58 cm (±0.41) and the oblique distance of the ostia from the anterior nasal spine was 5.35 cm (±0.48). Independent t tests showed that there is a statistically significant difference between the means of each of these parameters (p < 0.001) and their international averages.
The rate of ON protrusion is lower in the SEA population, whereas the rates of ON dehiscence, ICA dehiscence and ICA protrusion fall within the range of international averages. In our population, ACP pneumatization is not related to ON protrusion. The distance of the ostia from given landmarks was significantly shorter than in other studies.
外科医生若不了解蝶窦解剖标志的局部变异，可能会损伤位于蝶窦壁上的视神经（ON）或颈内动脉（ICA）。本研究旨在基于计算机断层扫描（CT）识别东南亚（SEA）人群中蝶窦及其相关周围结构的解剖变异。
本横断面研究利用Osirix软件分析了马来西亚一家三级转诊中心的300例脑部、鼻旁窦（PNS）以及头颈部（H&N）的CT扫描图像。图像在骨窗上重建为1毫米的切片。人口统计学细节和扫描结果记录在标准化数据收集表中。
SEA人群中视神经开窗、颈内动脉开窗和颈内动脉突出的发生率分别为7.0%、3.0%和10.0%。视神经突出发生率为2.3%。在卡方检验中，前床突（ACP）气化与视神经突出之间未发现统计学显著关系（p>0.05）。我们人群中Onodi气房的发生率为14.3%。窦口距后鼻孔顶部的平均垂直距离为1.42厘米（±0.32）。窦口距上鼻甲前端的水平距离为1.58厘米（±0.41），窦口距前鼻棘的斜距离为5.35厘米（±0.48）。独立t检验显示，这些参数各自的均值与国际平均值之间存在统计学显著差异（p<0.001）。
SEA人群中视神经突出发生率较低，而视神经开窗、颈内动脉开窗和颈内动脉突出发生率在国际平均范围内。在我们人群中，ACP气化与视神经突出无关。窦口距特定标志的距离明显短于其他研究。
