Selvet ERDOĞAN, Gürkan KESKİN, Murat TOPDAĞ, Fatih SARI, MURAT ÖZTÜRK, Mete İŞERİ

Bilgisayarlı tomografide sfenoid sinüs anatomik varyasyonları

Amaç: Bu çalışmanın amacı sinüziti olmayan hastalarda bilgisayarlı tomografi ile sfenoid sinüs anatomik varyasyonlarının belirlenmesidir. Elde edinilen bilgiler benzer çalışmalarla karşılaştırılarak literatüre katkı amaçlanmıştır. Materyal ve Metod: Çalışmada retrospektif 120 hastanın (55 erkek, 65 kadın) paranazal sinüs bilgisayarlı tomografi görüntüleri multiplanar reformat yöntemi ile incelendi. Sfenoid sinüs varyasyonları kaynaklandığı yapıya göre değerlendirildi. Bulgular: Karotid kanal protrüzyonu %45,8 ile en fazla gözlemlenen anatomik varyasyon oldu. Onu %34,16 ile onodi hücreleri takip etti. Karotid kanal dehissansı %2,50 olarak gözlemlendi ve de en az gözlemlenen varyasyon oldu. Sonuç: Sonuçlar değerlendirildiğinde internal karotid kanal protrüzyonu ve onodi hücresi Türk toplumunda sık rastlanılan varyasyonlardır. Bu yüzden operasyon ile sfenoid sinüse müdahale edilecek hastalarda özellikle dikkat edilmelidir.

Anahtar Kelimeler:

Paranazal Sinüsler, Anatomi, Bilgisayarlı Tomografi

Sphenoid sinus anatomic variations in computed tomography

Aim: The aim of this study is to identify antomical variations of the sphenoid sinuses in computed tomography images of non-sinusitis patients. Obtained data has been compared to some similar studies and in order to make contributions to the literature. Material and Methods: Computed tomography images of the sphenoid sinuses of 120 patients (55 males, 65 females) were retrospectively evaluated with multiplanar reformatted tecnique. Anatomical variations of the sphenoid sinuses were identify according to their origins. Results: We observed protrusion of the internal carotid artery (45,8%) and it the most common anatomic variation. It was followed by onodi cells (34,16%). Persantage of the internal carotid artery dehiscence was %2,50. So dehiscence of internal carotid artery were identified the least variations. Conclusion: Consequently, protrusion of internal carotid artery and onodi cell are common in Turkish population. Therefore, it should be very careful in patients undergoing especially sphenoid sinus operation.

Keywords:

Paranasal Sinuses, Anatomy, Computer Tomography,

___

Kasemsiri P, Thanaviratananich S, Puttharak W. The prevalence and pattern of pneumatization of Onodi cell in Thai patients. J Med Assoc Thai. 2011;94(9):1122-1126.
Cherla DV, Tomovic S, Liu JK, Eloy JA. The central Onodi cell: A previously unreported anatomic variation. Allergy Rhinol. 2013;4(1):49-51.
İsrafil O, Erkan S, Gökhan A, Fahrettin Y, Ömer FÇ, Tuğrul Ö. Paranazal sinüs anatomik varyasyonlarının bilgisayarlı tomografi ile analizi. Abant Med J. 2014;3(2):145-149.
Yüksel YG, Selçuk A, Dere H. Endoskopik sinüs cerrahisinde anatomik varyasyonların önemi. Turk Arch Otolaryngol. 2008;46(1):32-36.
Earwaker J. Anatomic Variations in Sinonasal CT. Radiographics. 1993;13(2):381-415.
Şahin C, Yılmaz YF, Titiz A, Özcan M, Özlügedik S, Ünal A. Paranazal Sinüslerin Anatomik Varyasyonları: Paranazal Sinüslerin Anatomik Varyasyonları: Bilgisayarlı Tomografi Çalışması. KBB ve BBC Dergisi. 2007;15(2):71-73.
Perez-Pinas, Sabate J, Carmona A, Catalina-Herrera CJ, Jimenez-Castellanos J. Anatomical variations in the human paranasal sinus region studied by CT. J Anat. 2000;197(2):221- 227.
Fadda GL, Rosso S, Aversa S, Petrelli A, Ondolo C, Succo G. Multiparametric statistical correlations between paranasal sinus anatomic variations and chronic rhinosinusitis. Acta Otorhinolaryngol Ital. 2012;32(4):244-251.
Kajoak SA, Ayad CE, Abdalla EA, Mohammed MN, Yousif MO, Mohammed AM. Characterization of Sphenoid Sinuses for Sudanese Population Using Computed Tomography. Glob J Health Sci. 2013;6(1):135-141.
Kaygusuz A, Haksever M, Akduman D, Aslan S, Sayar Z. Sinonasal anatomical variations: their relationship with chronic rhinosinusitis and effect on the severity of disease-a computerized tomography assisted anatomical and clinical study .Indian J Otolaryngol Head Neck Surg. 2014;66(3):260-266.
Tomovic S, Esmaeili A, Chan NJ, Shukla PA, Choudhry OJ, Liu JK, Eloy JA. High-resolution computed tomography analysis of variations of the sphenoid sinus. J Neurol Surg B Skull Base. 2013;74(2):82-90.
Lu Y, Pan J, Qi S, Shi J, Zhang X, Wu K. Pneumatization of the sphenoid sinus in Chinese: the differences from Caucasian and its application in the extended transsphenoidal approach. J Anat. 2011;219(2);132–142.
Sirikci A, Bayazit YA, Bayram M, Mumbuç S, Güngör K, Kanlikama M. Variations of sphenoid sinus and related structures. Eur Radiol. 2000;10(5):844-848.
Hewaidi G, Omami G. Anatomic Variation of Sphenoid Sinus and Related Structures in Libyan Population: CT Scan Study. Libyan J Med. 2008;3(3):128-133.
Delano MC, Fun FY, Zinrich SJ. Relationship of the optic nerve to the posterior paranasal sinuses: a CT anatomic study. AJNR Am J Neuroradiol. 1996;17(4):669-675.
Unal B, Bademci G, Bilgili YK, Batay F, Avci E. Risky anatomic variations of sphenoid sinus for surgery. Surg Radiol Anat 2006;28(2):195-201.
Fuji K, Chambers SM, Rhoton AL Jr. Neurosurgical relationships of the sphenoid sinus: A microsurgical study. J Neurosurg. 1979;50(1):31-39.
Dündar R, Kulduk E, Soy FK, Aslan M, Kılavuz AE, Sakarya EU, Yazıcı H, Eren A. Sfenoid sinüsteki septum varyasyonlarının radyolojik incelenmesi. Med Updates. 2014;4(1):6-10.
Turna1 O, Aybar MD, Karagoz Y, Tuzcu G. Anatomic Variations of the Paranasal Sinus Region: Evaluation with Multidetector CT. İstanbul Med. J 2014; 15(2): 104-109
Eweiss AZ, Ibrahim AA, Khalil HS. The safe gate to the posterior paranasal sinuses: reassessing the role of the superior turbinate. Eur Arch Otorhinolaryngol. 2012;269(5):1451-1456. 21. Kim HU, Kim SS, Kang SS, Chung IH, Lee JG, Yoon JH. Surgical anatomy of the natural ostium of the sphenoid sinus. Laryngoscope. 2001;111(9):1599-602.
Millar DA, Orlandi RR. The sphenoid sinus natural ostium is consistently medial to the superior turbinate. Am J Rhinol. 2006;20(2):180-181.
Al-Abri R, Bhargava D, Al-Bassam W, Al-Badaai Y, Sawhney S. Clinically Significant Anatomical Variants of the Paranasal Sinuses. Oman Med J. 2014;29(2):110-113.
Zada G, Agarwalla PK, Mukundan S Jr, Dunn I, Golby AJ, Laws ER Jr. The neurosurgical anatomy of the sphenoid sinus and sellar floor in endoscopic transsphenoidal surgery. J Neurosurg. 2011;114(5):1319-1330.
Başak S, Karaman CZ, Akdilli A, Mutlu C, Odabaşi O, Erpek G. Evaluation of some important anatomical variations and dangerous areas of the paranasal sinuses by CT for safer endonasal surgery. Rhinology. 1998;36(4):162-167.