Anatomical peculiarities of the sphenoidal sinus based on computed tomography data: structural types and correlation with maxillary sinuses

Detailed knowledge of anatomy and topography of sphenoidal and maxillary sinuses may help to improve surgical approaches, better predict postoperative complications, increase safety of surgical techniques, and, consequently, avoid inflammatory reactions. This also helps to determine the cause of inflammatory changes. Aim. This study aimed to analyze structural types of sphenoidal and maxillary sinuses by examining computed tomography (CT) images of the paranasal sinuses, to determine the frequency of the interposition of the internal carotid artery, and to identify sex- and age-related peculiarities and regularities in the extent of pneumatization and contents in the sphenoidal and maxillary sinuses. Materials and Methods. CT images of 50 patients who were receiving treatment in the otolaryngology unit of the Clinic of SamSMU were analyzed. Toshiba Aquilion 32 CT scanner was used. Results. Patients were divided into three groups according to Hamberger classification of the pneumatization of the sphenoidal sinus by taking into account the topographic relation to the sella turcica using CT data: the presellar type was identified in 10% (n=5) of the cases, the sellar type in 22% (n=11), and the postsellar type in 68% (n=34). The postsellar type is the most common structural type of the sphenoidal sinus. Moreover, patients were divided into groups by the type of pneumatization of the maxillary sinuses. No correlation was found between the pneumatizations of sphenoidal and maxillary sinuses. Moderate negative correlation was observed between age and structural type of the sinuses, and moderate positive correlation was found between the contents of the sinuses. Interposition of the internal carotid arteries was identified in 3 (6%) patients. Conclusions. Our data revealed that the postsellar type is the most common structural type of sphenoidal sinuses. The extent of pneumatization of the sphenoidal and maxillary sinuses is independent of each other. Anatomical peculiarities of the sphenoidal sinus in the form of the interposition of the internal carotid arteries are not very rare and should be taken into account in planning surgical interventions.