Introduction  The sphenoid sinus (SS) has a high variability; its anatomical relations and variations must be well understood prior to the expanded endoscopic surgery (EES) at the skull base via the endonasal transsphenoidal approach. A feared complication is injury to the internal carotid artery (ICA). Objective  To evaluate the anatomic variations of the SS and its relationship to the ICA using computed tomography (CT). Methods  Cross-sectional retrospective study. Analysis of 90 patients' CT scans on axial, coronal and sagittal planes with 1 mm slices, evaluating lateral and posterior extensions of pneumatization of the SS, deviation of the sphenoid septum, presence of septations and their relationship to the parasellar and paraclival segments of the internal carotid artery (psICA and pcICA, respectively). Results  The association between the protrusions of the psICA and the pcICA was statistically significant ( p  < 0.001), as was the association between the lateral extension of pneumatization of the SS and the protrusion of the psICA ( p  = 0.014). The presence of the posterior extension of pneumatization of the SS and protrusion of the pcICA occurred in 46% of the cases. Deviation of the sphenoid septum in the direction of the pcICA was present in 14% and dehiscence of the pcICA was seen in 3.6% of the cases. Conclusion  Using the CT scan to recognize the type of extensions of pneumatization of the SS, the deviation of the sphenoid septum, and the presence of septations is beneficial to identify accurately the ICA and to reduce the risk of injury to it.

Introduction:The fractures in the temporal bone are lesions that are observed in patients with traumatic brain injury (TBI). The computed tomography of high-resolution (CT) allows evaluating the fracture and the complications. Objective: Evaluate patients with TBI and temporal bone fracture. Way of study: Retrospective study. Method: Were evaluated 28 patients interned by TBI with clinical evidence and/or radiologic from temporal bone fractures. Results: The age ranged from 3 to 75 years. The most affected side was the right side 50% (n=14), left side 36% (n=10) and both sides 14% (n=4). The etiology of the trauma was the falling 25% (n=7), accidents with motorcycles and bicycles 21% (n=6), physical aggression 14% (n=4), running over 11% (n=3), fall of object 4% (n=1) and other causes 25% (n=7). The clinical signs were: Otorrhagia 78%, otalgia 11% (n=3), otorrhea 7% (n=2), facial paralysis 7% (n=2) and hearing loss 7% (n=2). The otoscopic findings: otorrhagia 57% (n=16), laceration of external auditory canal 36% (n=10), hemotympanum 11% (n=3), normal 7% (n=2) and Battle signal 7% (n=2). The findings for CT of skull were: with no alterations 54% (n=15) and temporal fracture 7% (n=2) and the CT of temporal bones were: line of fracture 71% (n=20), opacification of the mastoid 25% (n=7), glenoid cavity air 14% (n=1), dislocation of the ossicular chain 7% (n=2) and veiling of the middle ear 4% (n=1). Conclusion: Patients with TBI must be submitted to the otorhinolaryngological evaluation and imaging, for the early diagnosis of the complications and treatment. Keywords: temporal bone, fracture in the base of skull, computed tomography by X-ray.

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