Computerized Tomography Morphometric Analysis of the Sphenoid Sinus and Related Structures in Sudanese Population

Samih Awad Kajoak¹, Caroline Edward Ayad²*, Mohammed Najmeldeen³ and Elsafi Ahmed Abdalla²

¹College of Applied Medical Science, Diagnostic Radiology Department, Hail University-Saudi Arabia.

²College of Medical Radiological Science- Sudan University of Science and Technology, Khartoum-Sudan

³Radiology Department, Fedail Hospital, Khartoum, Sudan

*Corresponding Author E-mail: carolineayad@yahoo.com, carolineayad@sustech.edu; Phone: +249 0922044764

Accepted 11 July, 2014

Abstract

Sphenoid sinus is surrounded by critical structures and this can make sphenoid sinus surgeries difficult. The aim of this study was to characterize the sphenoid sinus and surrounding structures based on Computed Tomography (CT) for Sudanese subjects. Coronal CT scans of 201 patients were reviewed regarding the anatomical variations of the sphenoid sinus, degree of pneumatization, anterior clinoid process (ACP), greater wing of sphenoid bone (GWS), pterygoid process (PP), protrusion and dehiscence of internal carotid artery (ICA), optic nerve (ON), maxillary nerve (MxN) and vidian nerve (VN). The result showed that; the protrusion and dehiscence of (ICA) were found in 51 patients (25.4%) and 25 patients (12.4%) respectively. The protrusion and dehiscence of (ON) were present in 6 patients (3%) and 32 (15.9%) patients. The protrusion of (MxN) was encountered in 56 (27.9%) patients, and dehiscence of (MxN) was seen in 91 (45.3%) patients. Pneumatization of (ACP) was encountered in 28 patients (13.9%); it was bilateral in 9 (4.5%), on the right 9 (4.5%) and on the left 10 (5.0%). Pneumatization of the (GWS) was encountered in 70 patients, (34.8%) of whom 31 (15.4%) were bilateral, 13 (6.5%) were on the right side, and 26 (12.9%) were on the left side. Pneumatization of the (PP) was found in 81 patients, (40.3%) of whom 47 (23.4%), 10 (5%), and 24 (11.9%) were bilateral, right sided, and left sided, respectively. The data were analyzed statistically by using Chi- square test. There was a significant association between (ACP) pneumatization and (ICA) protrusion and (ON) dehiscence (p = 0.003), also a significant association between (GWS) pneumatization and (MxN) protrusion and (MxN) dehiscence (p = 0.003) was noted. Significant association between (PP) and (VN) protrusion and (VN) dehiscence (p = 0.004) was also noted. No significant differences were identified in the sphenoid sinus morphology between the two genders or age at p = 0.05. The knowledge on the anatomic variations and morphology of the sphenoid sinus and its related structures is important in order to avoid the surgical complications when entering the pituitary gland and sella turcica. Coronal tomography can successfully detect the sphenoid sinus morphology and anatomic variations.

Keywords: Sphenoid Sinus, Computerized Tomography, Pneumatization, Anatomical Variation.