Pneumatization of the paranasal sinuses: normal features of importance to the accurate interpretation of CT scans and MR images.

Scuderi, Anthony J.; Harnsberger, H R; Boyer, Richard S.

doi:10.2214/ajr.160.5.8470585

Cited by 210 publications

(155 citation statements)

References 4 publications

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“…The neurocranium encompasses the bones surrounding and protecting the brain and sensory organs -the endochondral bones of the base of cranium and sensory organs, and the dermal bones of the skull vault. The viscerocranium encompasses the bones of face and pharyngeal arches [5,26].…”

Section: Discussionmentioning

confidence: 99%

Association between frontal sinus development and persistent metopic suture

et al. 2013

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Section: Discussionmentioning

confidence: 99%

Association between frontal sinus development and persistent metopic suture

et al. 2013

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“…17 Gradual aeration of the sphenoid sinus affects not only the transsphenoidal corridor but also posteriorly expanded intracranial approaches reaching the cavernous sinus or the clivus. Scuderi et al 12 and Tatreau et al 17 show that the pneumatization pattern follows a strict inferior-to-superior and lateral direction. Our volumetric studies using MRI cuts [slices] in all 3 dimensions (coronal, midsagittal, and axial) further support this observation and demonstrate that aeration occurs at a relatively slow pace.…”

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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“…However, at birth it is the largest of the sinuses and may be seen radiographically (Levine & Clemente). According to Scuderi et al (1993) partial or complete opacification of the maxillary sinus may be normal in the first few years of life. This, therefore is confirmed in the current study results.…”

Section: Discussionmentioning

confidence: 99%

Shape, Septa and Scalloping of the Maxillary Sinus

2017

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RENNIE, C.; HAFFAJEE, M. R. & SATYAPAL, K. S.Shape, septa and scalloping of the maxillary sinus. Int. J. Morphol., 35(3):970-978, 2017. SUMMARY:The maxillary sinus varies according to age, however there are limited studies that have illustrated its 3D form over time. This study aimed to classify the maxillary sinus by the shape, number of septa and scallops in a 1 to 25 year age group, utilising computerized tomography (CT) scans and 3D reconstruction. CT scans (n=480) were reviewed from the picture archiving and communication system (PACS) of the state and private hospitals in Pietermaritzburg and Durban KwaZulu-Natal (KZN), South Africa. The sample consisted of 276 males and 204 females, 1-25 years and of two population groups, black African and white. SLICER 3D (www.slicer.org) was utilised in order to reconstruct a 3D model of the sinus. Morphological traits such as the presence of the sinus, scalloping and septa within the sinuses were categorised. In addition, the shape of the 3D model of the sinus was analysed anteriorly (coronal) and laterally (sagittal) adapting the classifications by Kim (1962) and Kim et al. (2002). The maxillary sinus was present bilaterally in n=477 individuals (99.4 %). Five different anterior shapes viz. Type 1 (triangular), Type 2 (upside down triangle), Type 3 (square), Type 4 (irregular) and Type 5 (rectangular) were identified in the anterior view. This shape was associated with age and population groups (p<0.05). In the lateral view, the maxillary sinus appeared to be quadrilateral with differences noted along the inferior wall. Intrasinus maxillary septa were more evident in the anterior region of the maxillary sinus (27.9 % right; 28.5 % left). The maxillary septa were commoner in females (37.9 % right; 39.4 % left) than in males (28.5 % right; 30.3 % left). They were also more commonly observed in the white cohort (63.8 % right; 68.1 % left) than in the black African cohort (29.1 % right; 30.5 % left). Scalloping in the axial plane from above along its anterior margin was also observed. An in-depth classification of the morphology of the 3D form of the maxillary sinus according to age (1 to 25 years) was established. Five different shapes in both the anterior and lateral view of the 3D model were observed. Anteriorly, it was noted that the main shape was Type 2 (upside down triangle). The shape of the sinus changed in the form according to age. Laterally, the shape was related to the development of the teeth, as the inferior wall of the sinus was classified. Maxillary septa and scalloping of the sinus were reported in all age groups. Surgically, the sinus morphology is essential for dental procedures such as sinus augmentation or dental implants, and anthropologically, in forensic identification.

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Pneumatization of the paranasal sinuses: normal features of importance to the accurate interpretation of CT scans and MR images.

Cited by 210 publications

References 4 publications

Association between frontal sinus development and persistent metopic suture

Association between frontal sinus development and persistent metopic suture

Impact of skull base development on endonasal endoscopic surgical corridors

Shape, Septa and Scalloping of the Maxillary Sinus

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