Department of Anatomy, Faculty of Medicine, Necmettin Erbakan University, Meram, Konya, 42090, Turkey.
Department of Anatomy, Faculty of Medicine, Aksaray University, Merkez, Aksaray, 68100, Turkey.
Neurosurg Rev. 2024 Jul 24;47(1):349. doi: 10.1007/s10143-024-02594-8.
Many studies revealed that the sphenoid sinus pneumatization (SSP) affects the protrusion/dehiscence of adjacent structures including optic canal (OC), foramen rotundum (FR), vidian canal (VC), and carotid canal (CC). Knowledge of this relationship bears vital importance to identify the safest surgical route during transsphenoidal procedures. Therefore, we aimed to determine the individualized prevalence of the protrusion/dehiscence of adjacent structures based on sagittal and coronal SSP (SSSP and CSSP) patterns. Computed tomography images of 300 patients were analysed to identify the SSSP and CSSP types, and the protrusion/dehiscence of adjacent structures was determined. The relationship between the variables was examined using statistical analysis in terms of age, gender, and laterality. The most prevalent SSSP type was postsellar (62.7%), followed by sellar (30%), presellar (6.6%), and conchal (0.7%). In 71.3% of patients, five types of CSSP were observed, with 23.6% and 21.7% exhibiting Type IV and V, respectively. Our results indicated that postsellar type, Type IV and V CSSP associated with the highest likelihood of protrusion/dehiscence of OC, FR, VC, and CC. Furthermore, no significant correlation was observed between these qualitative variables and gender, with the exception of the VC dehiscence, the protrusion of OC and CC. No notable differences were identified with respect to laterality. Also, the probability of having postsellar type, Type IV and V CSSP, as well as the protrusion of OC, VC, and CC, decreased with increasing age. Further detailed analysis of this association is required to predict the size of the surgical window and to prevent neurovascular injury.
许多研究表明，蝶窦气化（SSP）会影响毗邻结构的突出/缺损，包括视神经管（OC）、圆孔（FR）、翼管（VC）和颈动脉管（CC）。了解这种关系对于确定经蝶窦手术中最安全的手术路径至关重要。因此，我们旨在根据矢状位和冠状位 SSP（SSSP 和 CSSP）模式确定毗邻结构突出/缺损的个体患病率。对 300 名患者的 CT 图像进行分析，以确定 SSSP 和 CSSP 类型，并确定毗邻结构的突出/缺损情况。使用统计学分析检查变量之间的关系，包括年龄、性别和侧别。最常见的 SSSP 类型是鞍后（62.7%），其次是鞍内（30%）、鞍前（6.6%）和蝶窦型（0.7%）。在 71.3%的患者中，观察到 5 种 CSSP 类型，其中 23.6%和 21.7%分别为 IV 型和 V 型。我们的结果表明，鞍后型和 IV 型和 V 型 CSSP 与 OC、FR、VC 和 CC 突出/缺损的可能性最高。此外，除了 VC 缺损、OC 和 CC 突出与性别之间没有显著相关性外，这些定性变量之间没有相关性。此外，在侧别方面没有明显差异。此外，随着年龄的增长，出现鞍后型、IV 型和 V 型 CSSP 以及 OC、VC 和 CC 突出的概率降低。需要进一步详细分析这种相关性，以预测手术窗口的大小，并防止神经血管损伤。
