Department of Otolaryngology-Head and Neck Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
PLoS One. 2022 Aug 25;17(8):e0273545. doi: 10.1371/journal.pone.0273545. eCollection 2022.
We explored the clinical significances of the relationships among sphenoid sinus aeration, intersphenoid sinus septum (ISS), and internal carotid artery (ICA).
We retrospectively reviewed the preoperative paranasal sinus computed tomography scans and the medical charts of 490 patients who were treated by the endoscopic endonasal transsphenoidal approach. We analyzed sphenoid sinus pneumatization, number of ISS, and positional relationships between the ICA and ISS (including ICA prominence and the thickness of surrounding bone).
ISS were often present in the ICAs of patients with presellar pneumatization (36.2%; p = 0.042). Sphenoid sinus pneumatization status significantly differed according to number of ISS (p < 0.001), ICA prominence (p < 0.001), ISS insertion into the ICA (p = 0.042), and distance from ISS to ICA (p = 0.004). When sphenoid sinus aeration was poor, the ICA was not prominent, and the ISS were attached to or lay close to the paraclival ICA.
Patients with presellar pneumatization exhibited less prominent ICAs, and more ISS attached to or near the paraclival ICA, than did other patients. Therefore, particular caution is required when using the endoscopic endonasal transsphenoidal approach to treat patients with poor sphenoid sinus aeration.
探讨蝶窦气化、蝶窦中隔（ISS）和颈内动脉（ICA）之间关系的临床意义。
我们回顾性分析了 490 例接受内镜经鼻蝶入路治疗的患者的术前鼻窦 CT 扫描和病历。我们分析了蝶窦气化、ISS 数量以及 ICA 和 ISS 之间的位置关系（包括 ICA 突出和周围骨的厚度）。
ISS 常存在于蝶鞍前气化的患者的 ICA 中（36.2%；p=0.042）。蝶窦气化状态根据 ISS 数量（p<0.001）、ICA 突出（p<0.001）、ISS 插入 ICA（p=0.042）和 ISS 到 ICA 的距离（p=0.004）而显著不同。当蝶窦充气不良时，ICA 不突出，ISS 附着在或靠近斜坡旁 ICA。
与其他患者相比，蝶鞍前气化患者的 ICA 不突出，更多的 ISS 附着在或靠近斜坡旁 ICA。因此，在使用内镜经鼻蝶入路治疗蝶窦充气不良的患者时需要特别小心。
