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Assessment of Anatomical Variations, Prevalence, and Patterns of Optic Strut Using CBCT
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Roghayeh Panahi1   , Ali Honarvar , Gholamabbas Sabz , Hadi Ebrahimi , Ashkan Khoshnavataher |
| 1- , roghayehpanahi2@gmail.com |
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Abstract: (116 Views) |
Background and Objective: The optic strut (OS) is a critical bony structure at the skull base, significant in paranasal surgeries due to its proximity to the optic nerve and internal carotid artery and its association with paranasal sinuses (ethmoidal, sphenoidal, and Onodi cells). Pneumatization of the OS may increase the risk of surgical complications, such as optic nerve injury. This study aimed to investigate the anatomical variations, prevalence, and patterns of OS pneumatization using cone-beam computed tomography (CBCT) in the population of Yasuj in 2022.
Methods: Using simple random sampling, CBCT images of 339 patients were retrieved from the archives of maxillofacial radiology clinics in Yasuj. Images were evaluated directly on a monitor in sagittal, coronal, and axial planes. Pneumatization identification and pattern prevalence were assessed based on patients’ gender and the sphenoidal, ethmoidal, and Onodi cell pneumatization patterns, performed bilaterally by an otolaryngologist and a maxillofacial radiologist. Data analysis was conducted using SPSS version 26 with t-test and Chi-square tests, with a significance level set at 0.05.
Results: CBCT images from 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 provides 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.
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| Keywords: Optic Strut, pneumatization, sphenoid, ethmoid, Onodi cells, CBCT |
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Type of Study: Research |
Subject:
Clinical Surgery
Received: 2024/12/10 | Accepted: 2025/07/8 | Published: 2025/08/27
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