The total number of septa and antra in the sphenoid sinuses - evaluation before the FESS.

PURPOSE: The purpose of this research is to define the total number of septa and the total number of antra in the sphenoid sinuses (created as a result of the presence of additional septa), as well as the relation between the number of the septa and their location in the adult population. MATERIALS AND METHODS: e study was conducted as a retrospective analysis of the computed tomography (CT) scans of the paranasal sinuses of 296 patients (147 females and 149 males), who did not present any pathology in the sphenoid sinuses. The CT scans of the paranasal sinuses were done with the spiral CT scanner (Siemens Somatom Sensation 16) by using a standard procedure, in the option Siemens CARE Dose 4D, without using any contrast medium. A er obtaining the transverse planes, the frontal and sagittal planes were created using secondary reconstruction tool (multiplans reconstruction - MPR). RESULTS: The analysis of the obtained images in the transverse plane and secondary CT reconstructions has shown the presence of only one sphenoid septum (main septum - MS) in 21.96% of the patients, which divided the sphenoid sinus into two sphenoid antra. In 78.04% of the patients, there were more than one sphenoid septa present in the posterior part of the sphenoid sinuses, hence there were additional septa (AS) present. One AS was present in 22.97% of the patients. The most common variant - two AS - was found in 32.09% of the cases. The presence of more than two AS was found in the following number of patients: three AS in 9.8%, four AS in 7.09%, five AS in 1.69%, six AS in 3.04% and seven AS in 1.01%. The rarest variant was the presence of more than seven AS: eight AS in 0.34% and nine AS also in 0.34%. There were no sphenoid sinuses that would have more than nine AS in the researched material. CONCLUSIONS: Due to the high incidence of the anatomical variants of the paranasal sinuses, a CT scan is recommended in all patients before a planned surgery in order to avoid the potential complications that might arise as a result of the complicated structure of the paranasal sinuses.

[Anatomic variations of the septation within the sphenoid sinus on CT scan images--an initial report]. / Anatomiczna zmiennosc przegród w obrebie zatok klinowych w obrazowaniu spiralnej tomografii komputerowej--doniesienie wstepne.

AIM: The aim of this study was to assess the septation of the sphenoid sinuses and relationship between the number and position of septa in the adult Polish subpopulation. METHODS: A retrospective study of the CT examination of the paranasal sinuses 207 patients (101 male, 106 female) were performed using spiral multirow CT scanner (Siemens Somatom Sensation 10) with the following parameters: the extent fully covering all paranasal sinuses, detector configuration 10 x 0.75 mm, feed 4.1 mm, reconstruction thickness 1 mm, reconstruction increment 0.7 mm, kernel H60s for bone structures, or reconstruction thickness 4 mm, reconstruction increment 4 mm, kernel H31s for soft tissue structures. Secondary coronal and sagittal MPR's (multiplanar reconstructions) were then generated from original axial slices. No intravenous contrast media was required. Siemens CARE Dose 4D option was used to maximally reduce the X-ray dose. Since the aim of this study was to evaluate anatomical variations of sphenoidal sinuses septation only patients with no diseases within sphenoidal sinuses were included. All the subjects were Polish, with a mean age of 44 years, ranging from 18 to 84 years. RESULTS: In our study there was only one septum in 41%, two septa in 33%, three septa in 22% and four septa in 4%. The total amount of sinuses depending on total amount of septa (including accessory septa) and it can be different in the anterior and posterior part of the sphenoidal sinus. We also notice that the highest and the broadest septum (main septum) was completely bony in 57% whilst in 47% it was partially membranous. CONCLUSIONS: Performing CT of paranasal sinuses before surgery is essential to avoid potential complications resulting from anatomical variations.