Can Volumetric and Morphological Variants of Sphenoid Sinuses Influence Sinuses Opacification?

Abstract

Improvements in computed tomography and in functional endoscopic sinus surgery have recently increased interest toward paranasal sinus anatomy and anatomic variations that can be observed in patients affected by sinusitis. Isolated sphenoid sinusitis is a relatively rare pathology, often related to nonspecific symptoms, therefore making diagnosis difficult. The correlation between this type of sinusitis and anatomical variants remains unclear. The authors’ aim was to retrospectively revise paranasal sinuses computed tomography scans of patients affected by sphenoid sinusitis, compared with a control group, analyzing the types of sphenoid sinus and the presence of aberrant pneumatization, and performing a segmentation of the sphenoid sinuses to calculate the volumes. Sphenoid sinuses of 60 patients affected by sinus opacification, compared with a control group, were segmented. Type of sinus (sellar, presellar, postsellar) and presence of aberrant pneumatization were assessed as well. Possible statistically significant differences in volumes according to sex and group were assessed through 2-way ANOVA test (P < 0.05). Post-hoc test was assessed through Student t test. χ 2 test was applied in order to verify the statistically significance of differences in frequency of different types of sinus pneumatization variants (P < 0.05). Average volume of sphenoid sinuses in males was of 7.672 cm3 and of 7.751 cm3 in females within the group of patients; statistically significant differences in volume were found according to sex (P: 0.342), but not between the patients and control group (P: 0.0929). Post-hoc test verified that males affected by sinus opacification showed smaller volumes in comparison with the control males (P < 0.05). In addition, patients by affected sinus opacification showed more frequently the postsellar type and were less affected by pneumatization variants of the sphenoid bone than the control group (P < 0.05). This study first suggests the possible protective role of variants of pneumatization in the development of sphenoid sinus opacification.

Morphometric characteristics of the sphenoid sinus and potential influencing factors: a retrospective assessment using cone beam computed tomography (CBCT)

“…Although extension variability has been discussed in the literature using CT and magnetic resonance imaging techniques, there has been no CBCT based study yet. Gibelli et al highlighted a high frequency of the sellar type (74%) in their study (Gibelli et al 2018b). However, the post-sellar type was found to be most frequent (74.0%) in the present sample, which was in accordance with earlier data from Öksüzler et al andKim et al 2013b (Öksüzler et al 2019).…”

“…This is emphasized by the fact that partial or complete opacification of the SS may be indicative of a developing pathology such as mucocele, cavernous haemangioma, squamous cell carcinoma, adenoid cystic carcinoma, meningioma, or pituitary macroadenoma (Martin et al 2002). Hence, due to the thin walls of the SS, such pathologies may disseminate into intracranial structures, leading to fatal complications (Gibelli et al 2018b).…”

Segmentation procedures for the assessment of paranasal sinuses volumes

“…No significant differences were observed in volume between patients with and without SS opacification. 24…”

Correlation Between Anatomic Variations of Sphenoid Sinuses and Pituitary Adenoma

“…As the development of image processing skills, software such as ITK-SNAP can visualize different orientations, reconstruct 3D image, and access the volume automatically. Previous studies have discussed the correlation between anatomic variations (AVs) of SS and paranasal diseases 1,5,17,18 …”

“…Previous studies have discussed the correlation between anatomic variations (AVs) of SS and paranasal diseases. 1,5,17,18 In this paper, we compared AVs of SS between normal persons and PAs through ITK-SNAP software. Additionally, we investigated the factors associated with the volume of SS and discovered correlations between AVs of SS and PAs, which may contribute to a better clinical diagnosis and treatment guidance.…”