|
Study of Anatomical Variation, Prevalence, and Pattern of Optical Base Pneumatization Using CBCT
|
GA Sabz1   , A Honarvar , H Ebrahimi2 , A Khoshnavataher3 , SR Panahi4 |
1- Department of Surgery, Yasuj University of Medical Sciences, Yasuj, Iran
2- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
3- Student Research Committee, Yasuj University of Medical Sciences, Yasuj, Iran
4- Department of Oral and Maxillofacial Radiology, Yasuj University of Medical Sciences, Yasuj, Iran , roghayehpanahi2@gmail.com |
|
|
Abstract: (2158 Views) |
Background & aim: The optic pedicle is a key bony structure at the base of the skull that is essential in parasellar surgeries due to its proximity to the optic nerve and internal carotid artery and its connection to the paranasal sinuses (ethmoid, sphenoid, and occipital cells). Optic pedicle pneumatization can increase the risk of surgical complications such as optic nerve damage. Therefore, the aim of the present study was to determine and investigate the anatomical diversity, prevalence, and patterns of optic pedicle pneumatization using CBCT images in the population of Yasuj, Iran.
Methods: In the present descriptive-cross-sectional study conducted in 2022, information on 339 patients were collected from the archives of the maxillofacial radiology clinics of Yasuj using a simple random sampling method. CBCT images were collected, and the images were directly monitored on the monitor. CBCT images were examined in three sagittal, coronal, and axial planes. Identification of pneumatization and the frequency of its patterns based on the variables of the patients' gender and the pneumatization patterns of sphenoid, ethmoid, and odontoid cells was performed bilaterally by an otolaryngologist and a maxillofacial radiologist. The collected data were analyzed using t-test and chi-square tests.
Results: In the present study, CBCT images of 339 patients (64.30% female, 35.70% male) were analyzed. OS pneumatization was observed in 69.90% of patients (58.60% female, 41.40% male). The most common pattern was bilateral sphenoidal pneumatization (16.20%), followed by unilateral right-sided (15.30%) and unilateral left-sided (6.20%). Gender differences were significant only for the sphenoidal pattern (p=0.02), while ethmoidal and Onodi cell patterns showed no significant gender differences (p>0.05).
Conclusion: Knowledge of the prevalence and patterns of OS pneumatization, including sphenoidal, ethmoidal, and Onodi cell types, is crucial for reducing complications in paranasal surgeries, such as neurovascular injuries and cerebrospinal fluid leaks. This study provided a detailed classification of pneumatization patterns and recommends the use of surgical navigation systems and standardized radiology reporting to enhance safety and personalize skull base surgery protocols.
|
|
| Keywords: Optic Strut, Pneumatization, Sphenoid, Ethmoid, Onodi cells, CBCT |
|
|
Full-Text [PDF 582 kb]
(19 Downloads)
|
Type of Study: Research |
Subject:
Clinical Surgery
Received: 2024/12/10 | Accepted: 2025/07/8 | Published: 2025/08/27
|
|
|
|
|
|
|
| References |
1. Taghipour P, Çakır S, Hamzaoğlu V, Özalp H, Kara E, Vayisoğlu Y, et al. Fetal anatomy of the optic strut and prechiasmatic sulcus with a clinical perspective. World Neurosurgery 2020; 136: e625-e34.## [ DOI:10.1016/j.wneu.2020.01.125] [ PMID] 2. Jefferson G. Radiography of the optic canals. Proc R Soc Med 1936; 29: 1169-72. ## 3. Kapur E, Mehić A. Anatomical variations and morphometric study of the optic strut and the anterior clinoid process. Bosnian Journal of Basic Medical Sciences 2012; 12(2): 88. ## [ DOI:10.17305/bjbms.2012.2502] [ PMID] [ ] 4. Kerr RG, Tobler WD, Leach JL, Theodosopoulos PV, Kocaeli H, Zimmer LA, Keller JT. Anatomic variation of the optic strut: classification schema, radiologic evaluation, and surgical relevance. Journal of Neurological Surgery Part B: Skull Base 2012; 73(06): 424-9. ## [ DOI:10.1055/s-0032-1329626] [ PMID] [ ] 5. Kanellopoulou V, Efthymiou E, Thanopoulou V, Kozompoli D, Mytilinaios D, Piagkou M, Johnson EO. Prechiasmatic sulcus and optic strut: an anatomic study in dry skulls. Acta Neurochirurgica 2017; 159: 665-76. ## [ DOI:10.1007/s00701-017-3106-3] [ PMID] 6. Adanir SS, Ceylan ES, İnceoğlu A, Bahşi İ, Orhan M, Yalçin ED, Kervancioğlu P. Change in the location of the optic strut relative to the anterior clinoid process pneumatization. Journal of Craniofacial Surgery 2022; 33(6): 1924-8. ## [ DOI:10.1097/SCS.0000000000008707] [ PMID] 7. Suprasanna K, Ravikiran S, Kumar A, Chavadi C, Pulastya S. Optic strut and para-clinoid region-assessment by multi-detector computed tomography with multiplanar and 3 dimensional reconstructions. Journal of Clinical and Diagnostic Research: JCDR. 2015;9(10):TC06. ## [ DOI:10.7860/JCDR/2015/15698.6615] [ PMID] [ ] 8. Lee HY, Chung IH, Choi BY, Lee KS. Anterior clinoid process and optic strut in Koreans. Yonsei Medical Journal 1997; 38(3): 151-4. ## [ DOI:10.3349/ymj.1997.38.3.151] [ PMID] 9. Beer-Furlan A, Evins AI, Rigante L, Burrell JC, Anichini G, Stieg PE, Bernardo A. Endoscopic extradural anterior clinoidectomy and optic nerve decompression through a pterional port. Journal of Clinical Neuroscience 2014; 21(5): 836-40. ## [ DOI:10.1016/j.jocn.2013.10.006] [ PMID] 10. Giovannetti F, Mussa F, Priore P, Scagnet M, Arcovio E, Valentini V, Genitori L. Endoscopic endonasal skull base surgery in pediatric patients. A single center experience. Journal of Cranio-Maxillofacial Surgery 2018; 46(12): 2017-21. ## [ DOI:10.1016/j.jcms.2018.09.013] [ PMID] 11. Wasserzug O, DeRowe A, Ringel B, Fishman G, Fliss DM. Open approaches to the anterior skull base in children: review of the literature. Journal of Neurological Surgery Part B: Skull Base 2018; 79(01): 042-6. ## [ DOI:10.1055/s-0037-1621739] [ PMID] [ ] 12. Ten B, Balcı Y, Çakır S, Özalp H, Hamzaoğlu V, Vayisoğlu Y, et al. A computed tomography study of the prechiasmatic sulcus anatomy in children. World Neurosurgery 2020; 141: e118-e32. ## [ DOI:10.1016/j.wneu.2020.05.023] [ PMID] 13. Sicoe CT, Bichir C, Rusu MC. The Optic Strut-CBCT Pneumatization Pattern and Prevalence. Applied Sciences 2021; 11(13): 5797. ## [ DOI:10.3390/app11135797] 14. Gore MR. The supraseptal ethmoid sinus cell: A previously unreported ethmoid sinus variant. Clinical Case Reports 2019; 7(7): 1306-8. ## [ DOI:10.1002/ccr3.2215] [ PMID] [ ] 15. Xia Y. A Fronto-ethmoidal Sinus Mucocele presenting with optic disc edema. Radiology Case Reports 2021; 16(11): 3410-3. ## [ DOI:10.1016/j.radcr.2021.07.091] [ PMID] [ ] 16. Tesfaye S, Hamba N, Gerbi A, Negeri Z. Radio-anatomic variability in sphenoid sinus pneumatization with its relationship to adjacent anatomical structures and their impact upon reduction of complications following endonasal transsphenoidal surgeries. Translational Research in Anatomy 2021; 24: 100126. ## [ DOI:10.1016/j.tria.2021.100126] 17. Treviño-Gonzalez JL, Maldonado-Chapa F, Becerra-Jimenez JA, Soto-Galindo GA, Morales-del Angel JA. Sphenoid sinus: pneumatization and septation patterns in a Hispanic population. ORL. 2021; 83(5): 362-71. ## [ DOI:10.1159/000514458] [ PMID] 18. Ali IK, Sansare K, Karjodkar F, Saalim M. Imaging analysis of Onodi cells on cone-beam computed tomography. International Archives of Otorhinolaryngology 2020; 24(03): e319-e22. [ DOI:10.1055/s-0039-1698779] [ PMID] [ ] 19. Curragh DS, Valentine R, Selva D. Optic strut terminology. Ophthalmic Plastic & Reconstructive Surgery 2019; 35(4): 407-8. ## [ DOI:10.1097/IOP.0000000000001394] [ PMID] 20. Hindi K, Alazzawi S, Raman R, Prepageran N, Rahmat K. Pneumatization of mastoid air cells, temporal bone, ethmoid and sphenoid sinuses. Any correlation? Indian Journal of Otolaryngology and Head & Neck Surgery 2014; 66: 429-36. ## [ DOI:10.1007/s12070-014-0745-z] [ PMID] [ ] 21. Vaezi A, Cardenas E, Pinheiro‐Neto C, Paluzzi A, Branstetter IV BF, Gardner PA, et al. Classification of sphenoid sinus pneumatization: relevance for endoscopic skull base surgery. The Laryngoscope 2015; 125(3): 577-81. ## [ DOI:10.1002/lary.24989] [ PMID] 22. Herzallah IR, Saati FA, Marglani OA, Simsim RF. Retromaxillary pneumatization of posterior ethmoid air cells: novel description and surgical implications. Otolaryngology-Head and Neck Surgery 2016; 155(2): 340-6. ## [ DOI:10.1177/0194599816639943] [ PMID] 23. Wang J, Bidari S, Inoue K, Yang H, Rhoton Jr A. Extensions of the sphenoid sinus: a new classification. Neurosurgery 2010; 66(4): 797-816. ## [ DOI:10.1227/01.NEU.0000367619.24800.B1] [ PMID] 24. Jang YJ, Kim SC. Pneumatization of the sphenoid sinus in children evaluated by magnetic resonance imaging. American journal of rhinology 2000; 14(3): 181-6. ## [ DOI:10.2500/105065800782102771] [ PMID] 25. Kasemsiri P, Thanaviratananich S, Puttharak W. The prevalence and pattern of pneumatization of Onodi cell in Thai patients. Journal of the Medical Association of Thailand 2011; 94(9): 1122. ## 26. Ezhov M, Gusarev M, Golitsyna M, Yates JM, Kushnerev E, Tamimi D, et al. Clinically applicable artificial intelligence system for dental diagnosis with CBCT. Scientific Reports 2021; 11(1): 15006. ## [ DOI:10.1038/s41598-021-94093-9] [ PMID] [ ] 27. Walter C, Schmidt JC, Rinne CA, Mendes S, Dula K, Sculean A. Cone beam computed tomography (CBCT) for diagnosis and treatment planning in periodontology: systematic review update. Clinical Oral Investigations 2020; 24: 2943-58. ## [ DOI:10.1007/s00784-020-03326-0] [ PMID] 28. De Grauwe A, Ayaz I, Shujaat S, Dimitrov S, Gbadegbegnon L, Vande Vannet B, Jacobs R. CBCT in orthodontics: a systematic review on justification of CBCT in a paediatric population prior to orthodontic treatment. European Journal of Orthodontics 2019; 41(4): 381-9. ## [ DOI:10.1093/ejo/cjy066] [ PMID] [ ] 29. Zhang Y, Yue N, Su MY, Liu B, Ding Y, Zhou Y, et al. Improving CBCT quality to CT level using deep learning with generative adversarial network. Medical Physics 2021; 48(6): 2816-26. ## [ DOI:10.1002/mp.14624] [ PMID] [ ] 30. Mikami T, Minamida Y, Koyanagi I, Baba T, Houkin K. Anatomical variations in pneumatization of the anterior clinoid process. Journal of Neurosurgery 2007; 106(1): 170-4. ## [ DOI:10.3171/jns.2007.106.1.170] [ PMID] 31. Ominde BS, Ikubor J, Igbigbi PS. Pneumatization patterns of the sphenoid sinus in adult Nigerians and their clinical implications. Ethiopian Journal of Health Sciences 2021; 31(6): 44. ## [ DOI:10.4314/ejhs.v31i6.26] [ PMID] [ ] 32. Dedhia RD, Hsieh T-y, Rubalcava Y, Lee P, Shen P, Steele TO, Strong EB. Posterior maxillary sinus wall: a landmark for identifying the sphenoid sinus ostium. Annals of Otology, Rhinology & Laryngology 2019; 128(3): 215-9. ## [ DOI:10.1177/0003489418816725] [ PMID] 33. Hiremath SB, Gautam AB, Sheeja K, Benjamin G. Assessment of variations in sphenoid sinus pneumatization in Indian population: A multidetector computed tomography study. Indian Journal of Radiology and Imaging 2018; 28(03): 273-9. ## [ DOI:10.4103/ijri.IJRI_70_18] [ PMID] [ ] 34. Craiu C, Sandulescu M, Rusu MC. Variations of sphenoid pneumatization: a CBCT study. Romanian Journal of Rhinology 2015; 5(18): 107-13. ## [ DOI:10.1515/rjr-2015-0013] 35. Valizadeh S, Rezaiefard M, Mohammadpour M, Jamalzadeh N. Anatomical variations of the sphenoid sinus and its adjacent critical structures using cone beam computed tomography: a cross-sectional study. Journal of Iranian Medical Council 2023; 23: 44-8. ## [ DOI:10.18502/jimc.v6i2.12244] |
|
| Send email to the article author |
|
|
|
| Add your comments about this article |
|
|
|
|
|
