Burulday Veysel, Akgül Mehmet Hüseyin, Muluk Nuray Bayar, Ozveren Mehmet Faik, Kaya Ahmet
Faculty of Medicine, Radiology Department, Kırıkkale University, Kırıkkale, Turkey.
Faculty of Medicine, Neurosurgery Department, Kırıkkale University, Kırıkkale, Turkey.
Neurosurg Rev. 2017 Jul;40(3):403-409. doi: 10.1007/s10143-016-0794-8. Epub 2016 Oct 21.
In the present study, we investigated the types and ratio of posterior clinoid process (PCP) pneumatization in paranasal sinus multidetector computed tomography (MDCT). Paranasal MDCT images of 541 subjects (227 males, 314 females), between 15 and 65 years old, were included into the study. Pneumatization of anterior clinoid process and pneumatization types (I, II, or III) were evaluated in the males and females. PCP pneumatization was detected in 20.7 % of the males and 11.5 % of the females. Right, left, and bilateral PCP pneumatizations were detected in 7.9, 5.7, and 7.0 % of the males and 2.9, 3.2, and 4.5 % of the females, respectively. PCP pneumatization of the males is significantly higher than the females. The most detected type of pneumatization was type I (61.2 %) for all groups. In right, left, and bilateral pneumatizations separately, type I pneumatization was the most detected pneumatization type with the ratio of the 70.4, 65.2, and 50.0 %, respectively. In males, type I (61.7 %), and similarly in females, type I (60.6 %) pneumatization were detected more. Type II and type III pneumatizations were detected in decreasing order in both groups. In younger subjects, pneumatization of posterior clinoid process was found as higher, and in older subjects, PCP pneumatization was found as lower. Sclerosis process related to the aging may be responsible for the lower pneumatization ratios in older subjects. Structure of the surrounding regions of PCP is important for surgical procedures related to cavernous sinus, basilar apex aneurysms, and mass lesions. Preoperative radiological examinations are useful for operative planning. Any anomalies to PCP can cause unnecessary injury to the neurovascular complex structure around the cavernous sinus or postclinoidectomy CSF fistulas. Posterior clinoidectomies should be avoided in patients with type III PCP pneumatization to prevent CSF fistulas.
在本研究中，我们在鼻窦多排螺旋计算机断层扫描（MDCT）中研究了后床突（PCP）气化的类型和比例。纳入研究的是541名年龄在15至65岁之间的受试者（227名男性，314名女性）的鼻窦MDCT图像。对男性和女性的前床突气化及气化类型（I型、II型或III型）进行了评估。在20.7%的男性和11.5%的女性中检测到PCP气化。在男性中，右侧、左侧和双侧PCP气化的检测率分别为7.9%、5.7%和7.0%；在女性中，分别为2.9%、3.2%和4.5%。男性的PCP气化率显著高于女性。所有组中最常检测到的气化类型为I型（61.2%）。在右侧、左侧和双侧气化中，I型气化分别以70.4%、65.2%和50.0%的比例成为最常检测到的气化类型。在男性中，I型气化检测率更高（61.7%），同样，在女性中，I型气化检测率也更高（60.6%）。在两组中，II型和III型气化的检测率依次降低。在较年轻的受试者中，后床突气化程度较高，而在较年长的受试者中，PCP气化程度较低。与衰老相关的硬化过程可能是年长受试者气化率较低的原因。PCP周围区域的结构对于与海绵窦、基底动脉尖动脉瘤及肿块病变相关的手术操作很重要。术前影像学检查对手术规划很有用。PCP的任何异常都可能导致海绵窦周围神经血管复合结构的不必要损伤或后床突切除术后脑脊液漏。对于III型PCP气化的患者，应避免后床突切除术以防止脑脊液漏。
