Anatomical Variants of Internal Carotid Artery-Results from a Retrospective Study.

Background and Objectives: The internal carotid artery (ICA) is a vascular structure that can be easily injured during sinus endoscopic procedures, and surgeons should be familiar with its anatomic variants. The aim of this study was to describe the anatomical variations in the internal carotid artery in relationship to sphenoidal sinuses, using computed tomography (CT). Materials and Methods: In this retrospective study, we evaluated the variations of the ICA in relationship to sphenoidal sinuses in a cohort of 600 patients who were assessed between January 2020 and December 2022 in 'Saint Spiridon' Emergency Hospital, Iasi, Romania. Descriptive statistics were used to characterize our data. Results: The most prevalent anatomical variant was represented by intrasinusal septa with posterior insertion on the ICA (58.6%), followed by procident ICA (58%) and dehiscent ICA (52%). We could not find any statistical significance regarding demographic characteristics among groups. Conclusions: A thorough CT examination should be performed before functional endoscopic sinus surgery, with the identification of anatomical variants of the ICA, in order to prevent its injury with potentially fatal consequences.

The anatomo-radiological study of unusual extrasinusal pneumatizations: superior and supreme turbinate, crista galli process, uncinate process.

INTRODUCTION: One of the aspects that have an influence on rhinosinusal endoscopic surgery is extrasinusal pneumatization, which can also affect less common structures at this level. The pneumatization of the superior and supreme turbinates, uncinate process and crista galli are perfect examples of this situation. The diagnosis is made only through imaging methods. MATERIALS AND METHODS: This is a retrospective anatomo-radiological study analyzing 205 CT scans of the facial sinuses performed over a three years period. All patients were symptomatic and the CT scans were performed to assess the cases prior to surgery. Ninety-seven patients were females and 108 males, aged between 18 and 91 years. RESULTS: The prevalence of pneumatization and the prevalence of the different pneumatization types (superior and supreme turbinate, uncinate process and crista galli) were determined. CONCLUSIONS: The pneumatization of the supreme turbinate (10.24%) was less common than that of the superior turbinate (29.76%) and affected all its anatomical variations (A, B, C). Pneumatization of the crista galli process was recorded in 22.92% of the cases, especially in association with type 2, while the prevalence of pneumatized uncinate process was of only 3.41% (uni- or bilateral).

[Anatomical variations of landmarks in endoscopic surgery of the paranasal sinuses revealed by MRI imaging]. / Variante anatomice ale reperelor din chirurgia endoscopica a sinusurilor paranazale evidentiate imagistic prin RMN.

Continue development of endoscopic techniques of rinosinusal approach involves knowledge about the anatomy of this region, with a three-dimensional orientation before surgery, a therapeutic plan well thought, anticipating the gesture controller, taking into account the particularities of each case. Endoscopic surgical anatomic variants parts at this level can be well identified by imaging methods (CT, MRI). CT study of patients who are candidates for surgery Fess is on top, as the technique of choice. MRI is the imaging method to supply the CT data, providing a study carried out the normal anatomy and standard deviation of the numerous variants, single or in combination. This paper aims a randomized retrospective study of 120 MRI of the head and face region, to investigate and highlight the anatomical variations of structures at this level of impact and those with sinusitis etiopatologia, as well as those with operative risk (bleeding complications, ocular, vital risk) to determine the prevalence in the general population and have to compare the data with the literature. Using all sections (axial, sagittal and coronal) with the aid of different sequences (T1, T2, Flair and diffusion) allowed study of three-dimensional images of whole rhino-sinus-related pathology. Anatomic variations of surgical landmarks have investigated a wide range of expression, which are unique or associated with a complex architecture, with sufficient accuracy and visible on MRI. Their prevalence in the group studied was generally consistent with the literature studied.