The course of the main septum in the sphenoid sinuses - evaluation before the FESS.

The purpose of this study was to determine the course of the main septum (MS) in the sphenoid sinuses in the adult population. Materials and Methods: 296 patients (147 females, 149 males), who did not present any pathology in the paranasal sinuses, were included in this retrospective analysis of the computed tomography (CT) scans. Spiral CT scanner (Siemens Somatom Sensation 16) was used in order to glean the images of the paranasal sinuses, using standard procedure, in the option Siemens CARE Dose 4D, without using any contrast medium. Secondary reconstructions of the sagittal and frontal planes were obtained using multi- plans reconstruction (MPR) tool after obtaining transverse planes in the first instance. R e s u l t s: The course of the MS changed the most often from the anterior to the posterior part of the sphenoid sinuses. Such situation took place in 83.78% of the patients, in 32.43% of whom a clear shift to the lateral side was noticed only in the posterior part of the MS: in 18.24% of the patients to the right side, and in 14.19% of the patients to the left side. In 17.57% of the patients the lateral shift was visible in both anterior and posterior parts of the septum, where in 9.46% of the patients it was from the left side to the right, whereas in 8.11% of the patients the shift took place from the right side to the left. The MS had the shape of the letter 'C' in 22.29% of the cases, and 11.82% had the typical shape of the letter 'C,' and in 10.47% of the patients it paralleled the inverted letter 'C' (upside down). Amongst the types of the MS shifting directions the rarest was the MS that resembled the letter 'S' - 11.48% of the patients. In 5.74% of the cases it looked like the typical letter 'S,' and in 5.74% of the cases it was similar to the inverted letter 'S.' Only 16.22% of the cases had the MS that did not change its course nor its shape and ran medially in the sagittal plane from the anterior to the posterior part of the sinuses. Conclusions: In furtherance of reducing the risk of problems occurring during a surgery in the paranasal sinuses, it is prudent to have a CT scan done in all the patients beforehand, due to the high prevalence of the anatomical variations in the sinuses.

The height and type of the main septum in the sphenoid sinuses - evaluation before the fess.

The purpose of this study was to examine the height of the main septum (MS) in the sphenoid sinuses and its type, depending on the percentage prevalence of its tissue composition (osseous and membranous) in the adult population. Materials and Methods: A retrospective analysis of 296 computed tomography (CT) scans (147 females, 149 males) of the paranasal sinuses was conducted. The patients did not present any pathology in the sphenoid sinuses. The CT scans of the paranasal sinuses were carried out with a spiral CT scanner (Siemens Somatom Sensation 16) in a standard procedure, in the option Siemens CARE Dose 4D. No contrast medium was used. Having obtained the transversal planes, a secondary reconstruction tool (multiplans reconstruction - MPR) was used in furtherance of gleaning sagittal and frontal planes. R e s u l t s: In all cases, the height of the MS was measured by using a straight line running parallel to the course of the septum (when the MS was regarded as straight) or curved (when the MS was regarded as irregularly shaped). The average height of the MS was 2.1 ± 0.41 cm in the whole research group. Completely osseous MS was found in 32.77% of the patients. In 63.85% of them, the MS was partially membranous. The rarest was the MS which was not even partially ossified - a membranous type, that was observed in 3.38% of the patients. C o n c l u s i o n s: Variant anatomy of the paranasal sinuses may lead to complications encountered during a surgery, hence a CT scan is advised before the planned treatment.

Incorporation of the sphenoid sinuses' septum / septa in the carotid canal - evaluation before the FESS.

The purpose of the research was to define the frequency prevalence of the incorporation of sphenoid sinuses' septum / septa in the carotid canal of the adult population. MATERIALS AND METHODS: 296 computed tomography (CT) scans of the patients (147 females, 149 males), who did not present any pathology in the sphenoid sinuses, were evaluated in this retrospective analysis. Spiral CT scanner - Siemens Somatom Sensation 16 - was used to glean the medical images. Standard procedure applied in the option Siemens CARE Dose 4D. No contrast medium was administered. Multiplans reconstruction (MPR) tool was used in order to obtain frontal and sagittal planes from the transverse planes previously received. RESULTS: Bilateral incorporation of the main septum (MS) in the carotid canal was not present in any of the patients, whereas unilateral incorporation was noticed in 21.96% of the patients (17.68% females, 26.17% males). On the right side it occurred in 11.82% of cases (10.88% females, 12.75% males), and on the left side in 10.14% of cases (6.8% females, 13.42% males). Bilateral incorporation of the additional septum (AS) was found in 8.45% of the patients (4.08% females, 12.75% males), whereas unilateral incorporation was noted in 28.37% of the patients. It was seen on the right side in 11.82% of cases (12.93% females, 10.74% males), and on the left side in 16.55% cases (15.65% females, 17.45% males). The most common variant was the incorporation of only one of the septa (either the MS or the AS) in the wall of the carotid canal unilaterally. Such situation took place in 30.07% of the patients (29.25% females, 30.87% males). Incorporation of two septa on the same side was noticed in 4.39% of cases (4.08% females, 4.7% males), and incorporation of three septa in 0.34% of cases (0.7% males). CONCLUSIONS: The anatomy of the paranasal sinuses is varied to a great extent, hence performing a CT scan is crucial before the scheduled surgery, as it may lessen the unforeseeable surgical complications, that may result from the high prevalence of variants in the sinuses.

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.