Feasibility and Safety of Superolateral Sphenoidotomy: Radiologic Study by Analyzing Multiplanar Reconstructive CT Scans

Chung, Sung Won; Mo, Ji Hun; Chung, Young Jun

Abstract

BACKGROUND AND OBJECTIVES
The sphenoidotomy removing inferomedial side of anterior sphenoid wall has been the standard procedure to enter the sphenoid sinus. In this paper, we evaluated the feasibility and safety of superolateral sphenoidotomy based on the radiological analysis of the sphenoid sinus.
SUBJECTS AND METHOD
Seventy-six multiplanar reconstructive computed tomography (CT) scans were reviewed to investigate dimensions of the sphenoid sinus. We measured the length from sphenoid ostium to optic canal and to carotid artery, and also measured the thickness of both upper and lower bony part of sphenoid ostium. The subjects were divided into two groups; one with sphenoid sinusitis and the other without sinusitis and all the measurements were evaluated and were compared between groups.
RESULTS
The mean length from sphenoid ostium to optic canal were 13.8+/-2.4 mm in control group and 12.9+/-2.2 mm in sinusitis group. The length from sphenoid ostium to carotid artery were 10.4+/-1.5 mm and 10.0+/-1.8 mm in control and sinusitis group, respectively. There were significant differences in both lengths between control and sinusitis group. The bony thickness above and below the ostium were 1.48+/-0.31 mm and 1.73+/-0.27 mm respectively and were significantly different from each other (p<0.001).
CONCLUSION
Since the neurovascular structures was relatively distant from the sphenoid ostium and the bony thickness below the ostium was significantly thicker than that above the ostium, the sphenoidotomy removing superolateral side of anterior sphenoid wall could be an alternative procedure, especially, in patients with a thickened bone around sphenoid ostium.