Otolaryngology and Head and Neck Surgery Division, School of Medicine and University Hospital "Dr. Jose E. González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico.
Otolaryngology and Head and Neck Surgery Division, School of Medicine and University Hospital "Dr. Jose E. González", Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico.
Neurocirugia (Astur : Engl Ed). 2023 May-Jun;34(3):105-111. doi: 10.1016/j.neucie.2022.11.011. Epub 2023 Feb 9.
Anatomical variations of the lateral recess of the sphenoid sinus and its relations with the adjacent neurovascular structures should be preoperatively evaluated to plan an adequate surgical approach and avoid iatrogenic injuries. This study aims to analyze the patterns of pneumatization of the lateral recess of the sphenoid sinus and their association with the presence of protrusion and dehiscence of the optic canal, carotid canal, vidian canal, and maxillary nerve.
A retrospective evaluation of 320 sphenoid sinuses by computed tomography was performed. Studied variables included type of lateral recess, and protrusion, and dehiscence of the optic and carotid canal, and vidian and maxillary nerve.
The mean age was 45.67±17.43. A total of 55.6% (n=178) of the evaluated sphenoid sinuses corresponded to male subjects. Protrusion of the carotid canal, maxillary nerve, and vidian canal was associated with a type 3 lateral recess pneumatization, while dehiscence of these structures was most commonly observed in a type 2 lateral recess (p=<0.001).
Protrusion or dehiscence of neurovascular structures surrounding the sphenoid sinus has been associated with the extent of pneumatization of the lateral recess, increasing the risk of intraoperative injury. Preoperative identification of anatomical variations is mandatory to select the best approach for skull base lesions and avoid iatrogenic injuries.
在计划充分的手术入路和避免医源性损伤之前，应该对蝶窦外侧隐窝的解剖变异及其与相邻神经血管结构的关系进行术前评估。本研究旨在分析蝶窦外侧隐窝的气化模式及其与视神经管、颈动脉管、翼管和上颌神经突起和裂开的关系。
对 320 例蝶窦进行了计算机断层扫描的回顾性评估。研究变量包括外侧隐窝的类型，以及视神经管和颈动脉管、翼管和上颌神经的突起和裂开。
平均年龄为 45.67±17.43 岁。所评估的蝶窦中，男性占 55.6%（n=178）。颈动脉管、上颌神经和翼管的突起与 3 型外侧隐窝气化有关，而这些结构的裂开最常见于 2 型外侧隐窝（p=<0.001）。
蝶窦周围神经血管结构的突起或裂开与外侧隐窝的气化程度有关，增加了术中损伤的风险。术前识别解剖变异对于选择最佳的颅底病变入路和避免医源性损伤是必要的。
