title: Sphenoid sinus types, dimensions and relationship with surrounding structures.
abstract: The human sphenoid sinus is an extremely variable cavity and an important landmark in hypophyseal surgery. The aim of this study was to investigate the relationship between the sphenoid sinus type, size, extent of pneumatization and occurrence of protrusions of the adjacent neurovascular structures. A total of 51 randomly selected skulls (≥20 years of age, 33 male; 102 sinuses) were analyzed using cone beam computed tomography to estimate pneumatization extension beyond the body of the sphenoid (planum sphenoidale, pterygoid process, greater wings, clivus, dorsum sellae) and protrusions of the maxillary, mandibular, optic or pterygoid nerve or the internal carotid artery. Difference in pneumatization type between the left and the right-sided sinus was observed in 45% of the skulls. Conchal pneumatization was registered in 2%, presellar in 24%, sellar in 41% and postsellar in 33% of total sinuses. Presellar sinuses frequently pneumatized planum sphenoidale and sporadically other structures, and were characterized by sporadic optic nerve protrusions. Sellar and particularly postsellar sinuses were characterized by simultaneous pneumatization extensions and neurovascular protrusions. In the case of postsellar-type sinuses, the probability of these multiple interactions was not affected by their actual size, while it increased with the increasing sinus dimensions in the case of sellar-type sinuses. A more detailed analysis indicated that increasing sinus height, length or width increased the probability of interactions and pneumatization of particular surrounding structures. Data suggest that the sphenoid sinus pneumatization type and dimensions might be used to estimate the risks of iatrogenic injury during transsphenoidal surgical procedures.
authors.affiliation: Laboratory for Mineralized Tissues, Center for Translational and Clinical Research, School of Medicine, University of Zagreb, Šalata 11, 10000 Zagreb, Croatia.
authors.forename: Nikola
authors.initials: N
authors.lastname: Štoković
authors.affiliation: Department of Pharmacology, School of Medicine, University of Zagreb, Croatia, Šalata 11, 10000 Zagreb, Croatia.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Trkulja
authors.affiliation: Laboratory for Mineralized Tissues, Center for Translational and Clinical Research, School of Medicine, University of Zagreb, Šalata 11, 10000 Zagreb, Croatia.
authors.forename: Ivo
authors.initials: I
authors.lastname: Dumić-Čule
authors.affiliation: Department of Paediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Croatia, Gundulićeva 5, 10000 Zagreb, Croatia; Department of Dental Medicine, University Hospital Center Zagreb, Croatia, , Kišpatićeva 12, 10000 Zagreb, Croatia.
authors.forename: Ivana
authors.initials: I
authors.lastname: Čuković-Bagić
authors.affiliation: Department of Anthropology, Faculty of Social Sciences and Humanities, University of Zagreb, Lučićeva 3, 10000 Zagreb, Croatia; Department of Otorhinolaryngology and Maxillofacial Surgery, Faculty of Medicine, University of Osijek, Huttlerova 4, 31000 Osijek, Croatia.
authors.forename: Tomislav
authors.initials: T
authors.lastname: Lauc
authors.affiliation: Laboratory for Mineralized Tissues, Center for Translational and Clinical Research, School of Medicine, University of Zagreb, Šalata 11, 10000 Zagreb, Croatia.
authors.forename: Slobodan
authors.initials: S
authors.lastname: Vukičević
authors.affiliation: Laboratory for Mineralized Tissues, Center for Translational and Clinical Research, School of Medicine, University of Zagreb, Šalata 11, 10000 Zagreb, Croatia. Electronic address: lgrgurev@mef.hr.
authors.forename: Lovorka
authors.initials: L
authors.lastname: Grgurević
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001808:Blood Vessels / Q000033:anatomy & histology; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009900:Optic Nerve / Q000033:anatomy & histology; D012658:Sella Turcica / Q000033:anatomy & histology; D012886:Skull / Q000033:anatomy & histology; D013100:Sphenoid Bone / Q000033:anatomy & histology; D013101:Sphenoid Sinus / Q000033:anatomy & histology* / Q000098:blood supply / Q000294:innervation; D044465:White People; D055815:Young Adult
keywords: Anatomical variation; CBCT; Hypophyseal surgery; Neurovascular protrusion; Pneumatization; Sphenoid sinus