Le sinus sphénoïdal pendant l'enfance : aspects en IRM du developpement normal

Szolar, Dieter; Preidler, Klaus W.; Ranner, G.; Braun, H; Kugler, Ch.; Wolf, Gerald; Stammberger, Heinz R.; Ebner, Franz

doi:10.1007/bf01627594

Cited by 35 publications

(37 citation statements)

References 16 publications

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“…In various literature studies, the incidence of a single septum has been reported as 33-95 percent. [11] With a few specific exemplary cases the incidence of a single septum was reported as 77% (Szolar et al) [12] and 71% (Hamid et al), [13] while we found single septum (single complete+single incomplete) in 90.7% of our cases. These studies indicated that septa were mostly in the paramedian location and more frequently deviated to the right side.…”

Section: Discussionsupporting

confidence: 42%

Radiological evaluation of septal bone variations in the sphenoid sinus

Dündar¹

2014

J Med Updates

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ÖzetAmaç: Sfenoid sinüste yer alan septum, optik sinir ve internal karotid arter ile ilgili olarak varyatif durumlar›n belirlenmesi.Yöntem: Akut/kronik sinüzit tan›s›yla paranasal sinüs bilgisayarl› tomografi istenen 218 hasta retrospektif olarak taranm›flt›r. Bu hastalar›n tomografileri aksiyel ve koronal kesitlerde incelenerek sfenoid sinüs, kemik septa varyasyonlar›, say› ve uzan›m flekli yönünden s›n›f-land›r›lm›fl, ayr›ca optik sinir ve internal karotid arter protrüzyon valanslar› hesaplanm›flt›r.Bulgular: Radyolojik inceleme sonucunda 5 tip septa varyasyonu saptanm›flt›r. Yüz otuz iki adet (%60,5) tek komplet septumlu, 66 adet (%30.2) tek inkomplet septumlu, 6 adet (%2.7) çift septumlu (komplet+inkomplet), 9 adet (%4.1) çift septumlu (komplet+komplet) ve 5 adet (%2.2) septumu olmayan sfenoid sinüs tan›mlanm›flt›r. Tek olan septumlar›n %64 oran›nda orta hatta oldu¤u, di¤er tiplerin ise orta hatt›n hemen sa¤ veya solundan bafllad›¤› izlenmifltir. Ayr›ca optik sinir ve internal karotid arter protruzyon oranlar› (n=39) 17.8% ve (n=61) %27.9 olarak bulunmufltur. Sonuç: Cerrahi öncesi bilgisayarl› tomografi ile yap›lan de¤erlendir-me ve cerrahi planlama, endoskopik giriflimler için çok büyük önem tafl›makta ve olas› majör cerrahi komplikasyonlar›n azalt›lmas›nda rol almaktad›r.Anahtar sözcükler: Endoskopik sinüs cerrahisi, sfenoid sinüs varyasyonlar›. AbstractObjective: To determine septal variations and rates of intrasinusal protrusions of optic nerve and internal carotid artery in sphenoid sinus. Methods:Retrospective analysis of spiral computed tomography scanning of paranasal sinuses of 218 patients diagnosed as acute/chronic sinusitis was performed. Bilateral sphenoid sinuses were evaluated as if a single sinus, septa of this sinus were evaluated in terms of number and configuration. Besides rates of optic nerve and internal carotid artery protrusions were determined.Results: A total of 5 types of septal variations were detected. A single complete septum (n=132; 60.5%), a single incomplete septum (n=66; 30.2%), double septum (complete + incomplete, n=6; 2.7%), two complete septa (n=9; 4.1%), and sphenoid sinuses without septum (n=5; 2.2%) were identified. Sixty-four percent of single septum was located in midline, while other types were found immediately right or left side of the midline. Besides, protrusions of optic nerve and internal carotid artery were detected in 39 (17.8%) and 61 (27.9%) cases, respectively. Conclusion:Preoperative evaluation with computed tomography and surgical planning dependent on these findings are very important for endoscopic interventions and these approaches minimize potential major intraoperative complications.

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Section: Discussionsupporting

confidence: 42%

Radiological evaluation of septal bone variations in the sphenoid sinus

Dündar¹

2014

J Med Updates

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“…In contrast, some anatomical and radiological studies demonstrated that sphenoid pneumatization begins during the first months of age and is usually completed within the first decade [22,23,24]. Detailed radiological assessment with computerized tomography and MRI is essential to investigate the anatomical variations of paranasal sinuses.…”

Section: Discussionmentioning

confidence: 99%

Transnasal Transsphenoidal Surgical Method in Pediatric Pituitary Adenomas

Taşkapılıoğlu¹,

Yılmazlar²,

Eren

et al. 2015

Pediatr Neurosurg

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Aim: To evaluate the clinical outcome in a 13-year consecutive series of children operated for pituitary adenomas with transnasal transsphenoidal surgery. Methods: All patients <18 years who were operated on at our center by transsphenoidal surgery for pediatric pituitary adenomas were included in the study. Clinical features, hormonal profile, radiology, surgical approach, results and complications were analyzed. Results: Eighteen patients (90%) had functional pituitary adenomas and 2 (10%) patients had nonfunctional pituitary adenoma. The most common type was prolactin-secreting adenoma (n = 12), followed by corticotropinoma (n = 4), growth hormone-secreting adenoma (n = 2), and nonfunctioning adenoma (n = 2). Prolactin-secreting adenomas in children occurred more commonly with suprasellar expansion than did other adenomas. Conclusion: Transsphenoidal surgery was effective for decompression of suprasellar extension and relieved the chiasmal compression immediately. Prolactin-secreting tumors required postoperative medical therapy for persistently elevated prolactin levels.

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“…Development of the skull base has been proven to be asynchronous and asymmetrical. 14,15 As growth of the midfacies accelerates in late childhood, 1 midsagittal craniocaudal expansion of the skull base also accelerates. However, we show that the dorsal portions have a more rapid development and reach maturation earlier, at 5-7 years, compared with the more anterior compartments of the cranial base.…”

Section: 19mentioning

confidence: 99%

Impact of skull base development on endonasal endoscopic surgical corridors

Banu

Guerrero-Maldonado

McCrea

et al. 2014

PED

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Object Scarce morphometric data exist on the developing skull base as a corridor for endonasal endoscopic approaches (EEAs). Furthermore, the impact of skull base lesions on its development has not been assessed. The authors describe a novel set of anatomical parameters characterizing the developmental process as well as the utility of these parameters in preoperative planning and a feasibility assessment of EEAs for neurosurgical treatment of skull base lesions in children. Methods Based on specific MRI sequences in 107 pediatric patients (2–16 years of age) without skull base lesions (referred to here as the normal population), 3 sets of anatomical parameters were analyzed according to age group and sex: drilling distance, restriction sites, and working distance parameters. A separate set of patients undergoing EEAs was analyzed in similar fashion to address the impact of skull base lesions on the developmental process. Results The volume of the sphenoid sinus significantly increases with age, reaching 6866.4 mm3 in the 14–16 years age group, and directly correlates with the pneumatization type (r = 0.533, p = 0.0001). The pneumatization process progresses slowly in a temporal-posterior direction, as demonstrated by the growth trend of the sellar width (r = 0.428, p = 0.0001). Nasal restriction sites do not change significantly with age, with little impact on EEAs. The intercarotid distance is significantly different only in the extreme age groups (3.9 mm, p = 0.038), and has an important impact on the transsphenoidal angle and the intracranial dissection limits (r = 0.443, p < 0.0001). The 14.9° transsphenoidal angle at 2–4 years has a 37.6% significant increase in the 11–13 years age group (p = 0.001) and is highly dependent on pneumatization type. Age-dependent differences between working parameters are mostly noted for the extreme age groups, such as the 8.6-mm increase in nare-vomer distance (p = 0.025). The nare-sellar distance is the only parameter with significant differences based on sex. Skull base lesions induce a high degree of variance in skull base measurements, delaying development and decreasing parameter values. Skull base parameters are interdependent. Nare-sellar distance can be used to assess global skull base development because it highly correlates with the intercarotid distance in both the normal population and in patients harboring skull base lesions. Conclusions Skull base development is a slow, gradual, age-dependent, sex-independent process significantly altering endonasal endoscopic corridors. Preoperative MRI measurements of the pediatric skull base are thus a useful adjunct in choosing the appropriate corridor and in assessing working angles and limits during dissection or reparative surgery. Skull base lesions can significantly impact normal skull base development and age-dependent growth patterns.

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Le sinus sphénoïdal pendant l'enfance : aspects en IRM du developpement normal

Cited by 35 publications

References 16 publications

Radiological evaluation of septal bone variations in the sphenoid sinus

Radiological evaluation of septal bone variations in the sphenoid sinus

Transnasal Transsphenoidal Surgical Method in Pediatric Pituitary Adenomas

Impact of skull base development on endonasal endoscopic surgical corridors

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