Efendić Alma, Muharemović Edin, Skomorac Rasim, Bečulić Hakija, Šestić Sabina, Halilović Benjamin, Mahmić-Kaknjo Mersiha
Department of Radiology, Cantonal Hospital Zenica, Zenica; Bosnia and Herzegovina.
Department of Ophthalmology, Cantonal Hospital Zenica, Zenica; Bosnia and Herzegovina.
Med Glas (Zenica). 2017 Feb 1;14(1):49-54. doi: 10.17392/875-16.
Aim To define direct anatomical relations of the sphenoidal (alae minores), ethmoidal sinuses and optic nerve, with an emphasis on determining the effect of age on pneumatisation and dehiscence. Methods This retrospective, descriptive study involved 60 consecutive patients: 30 patients younger than 30 and30 patients older than 60 years of age. All patients underwent computerized tomography(CT). The relationship of the optic nerve and the sphenoidal and ethmoidal sinuses was classified. The presence of dehiscence in the bone structures, forming the optic canal, was checked. Dehiscence was defined as absence of visible bone density located between the sinus and the optic nerve. Protrusion of the optic nerve into the sphenoidal sinus was defined as optic nerve surrounded by pneumatised space. Results The most common type of relation between the optic nerve and sphenoidal sinus was type I, where the optic nerve was immediately adjacent to the lateral or superior wall of the sphenoidal sinus, without impression on the sinus wall. Dehiscence was documented in 15 (25%) cases, it was more common in older patients (8, 27%) than in younger ones (7, 23%). The pneumatisation processes were more frequent in patients over 60 (5, 17%) than in those younger than 30 years (4, 13%). Conclusion Surgeons and ophthalmologists should be aware of high frequency of dehiscence of sphenoidal sinus walls when treating adult patients in our population, especially when evaluating risks and complications of surgical procedures or when diagnosing inflammatory or tumorous processes in the close vicinity of posterior paranasal sinuses.
目的 明确蝶窦（翼突小翼）、筛窦与视神经的直接解剖关系，重点是确定年龄对气化和骨质缺损的影响。方法 这项回顾性描述性研究纳入了60例连续患者：30例年龄小于30岁，30例年龄大于60岁。所有患者均接受了计算机断层扫描（CT）。对视神经与蝶窦和筛窦的关系进行分类。检查构成视神经管的骨结构中是否存在骨质缺损。骨质缺损定义为窦与视神经之间无可见骨密度。视神经突入蝶窦定义为视神经被气化空间包围。结果 视神经与蝶窦最常见的关系类型为I型，即视神经紧邻蝶窦外侧壁或上壁，窦壁无压迹。15例（25%）记录到骨质缺损，老年患者（8例，27%）比年轻患者（7例，23%）更常见。60岁以上患者（5例，17%）的气化过程比30岁以下患者（4例，13%）更频繁。结论 在治疗我国成年患者时，外科医生和眼科医生应意识到蝶窦壁骨质缺损的高发生率，尤其是在评估手术风险和并发症或诊断后鼻窦附近的炎症或肿瘤性病变时。
