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Vol. 34. Issue 3.
Pages 105-111 (May - June 2023)
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Vol. 34. Issue 3.
Pages 105-111 (May - June 2023)
Clinical Research
Neurovascular structures in the lateral recess of the sphenoid sinus. A computed tomography evaluation
Estructuras neurovasculares en el receso lateral del seno esfenoidal mediante tomografía computarizada
Jose Luis Treviño-Gonzalez, Karla Marisol Santos-Santillana, Felix Maldonado-Chapa, Josefina Alejandra Morales-Del Angel
Corresponding author
jamoralesorl@gmail.com

Corresponding author.
Otolaryngology and Head and Neck Surgery Division, School of Medicine and University Hospital “Dr. Jose E. González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo Leon, Mexico
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Figures (5)
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Tables (3)
Table 1. Sphenoid sinus pneumatization patterns and anatomical variations of neurovascular structures.
Table 2. Carotid and optic canal classification associated with lateral recess pneumatization types.
Table 3. Maxillary and vidian nerve classification associated with lateral recess pneumatization types.
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Abstract
Introduction and objectives

Anatomical variations of the lateral recess of the sphenoid sinus and its relations with the adjacent neurovascular structures should be preoperatively evaluated to plan an adequate surgical approach and avoid iatrogenic injuries. This study aims to analyze the patterns of pneumatization of the lateral recess of the sphenoid sinus and their association with the presence of protrusion and dehiscence of the optic canal, carotid canal, vidian canal, and maxillary nerve.

Materials and methods

A retrospective evaluation of 320 sphenoid sinuses by computed tomography was performed. Studied variables included type of lateral recess, and protrusion, and dehiscence of the optic and carotid canal, and vidian and maxillary nerve.

Results

The mean age was 45.67±17.43. A total of 55.6% (n=178) of the evaluated sphenoid sinuses corresponded to male subjects. Protrusion of the carotid canal, maxillary nerve, and vidian canal was associated with a type 3 lateral recess pneumatization, while dehiscence of these structures was most commonly observed in a type 2 lateral recess (p=<0.001).

Conclusions

Protrusion or dehiscence of neurovascular structures surrounding the sphenoid sinus has been associated with the extent of pneumatization of the lateral recess, increasing the risk of intraoperative injury. Preoperative identification of anatomical variations is mandatory to select the best approach for skull base lesions and avoid iatrogenic injuries.

Keywords:
Sphenoid sinus
Anatomic variation
Optic nerve
Internal carotid artery
Endoscopic surgical procedures
Hispanic
Resumen
Introducción y objetivos

Las variaciones anatómicas del receso lateral del seno esfenoidal, y su relación con las estructuras neurovasculares adyacentes deben ser evaluados de manera preoperatoria para planear un abordaje quirúrgico adecuado, y evitar lesiones iatrogénicas. El objetivo del presente estudio es analizar los patrones de neumatización del receso lateral del seno esfenoidal y su asociación con la presencia de protrusión y dehiscencia del canal óptico, canal carotídeo, canal vidiano y del nervio maxilar.

Material y métodos

Se realizó una evaluación retrospectiva de 320 senos esfenoidales por tomografía computarizada. Las variables estudiadas fueron el tipo de receso lateral y la protrusión y dehiscencia del canal óptico, canal carotídeo, canal vidiano y del nervio maxilar.

Resultados

La edad media de los pacientes fue de 45,67±17,43 años. Un total del 55,6% (n=178) de los senos esfenoidales evaluados correspondieron a pacientes del sexo masculino. La protrusión del canal carotídeo, nervio maxilar y canal vidiano se asoció a la neumatización de receso lateral tipo 3, mientras que la dehiscencia de estas mismas estructuras observó más frecuentemente en patrón de neumatización de receso lateral tipo 2 (p0,001).

Conclusión

La protrusión o dehiscencia de estructuras neurovasculares adyacentes al seno esfenoidal se han asociado con la extensión de la neumatización del receso lateral, aumentando el riesgo de lesiones intraoperatorias. La identificación preoperatoria de variantes anatómicas es crucial para seleccionar el mejor abordaje quirúrgico para lesiones de base de cráneo y evitar lesiones iatrogénicas.

Palabras clave:
Seno esfenoidal
Nervio óptico
Arteria carótida interna
Cirugía endoscópica nasal
Población hispana

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