J Korean Assoc Oral Maxillofac Surg.  2022 Aug;48(4):207-218. 10.5125/jkaoms.2022.48.4.207.

Investigation of the prevalence and main features of skull-base anomalies and characteristics of the sphenoid sinus using cone-beam computed tomography

• Akbulut A
• Demirel O
• Orhan K

• KMID: 2532821
• DOI: http://doi.org/10.5125/jkaoms.2022.48.4.207

Abstract

Objectives
This study aimed to define the prevalence and characteristics of skull base anomalies and the features of sphenoid sinus pneumatization (SSP).
Materials and Methods
Five hundred cone-beam computed tomography scans were evaluated retrospectively for the presence of fossa navicularis magna (FNM), canalis basilaris medianus (CBM), sphenoid emissary foramen (SEF), and/or Onodi cells (OC). Patterns of the SSP and sphenoid sinus mucosa dimensions (SSMD) were also recorded.
Results
The prevalence of FNM, CBM, SEF, and OC was 26.0%, 22.4%, 47.4%, and 18.4%, respectively. Two hundred sixty-two (52.4%) sellartype SSP were defined, followed by post-sellar 191 (38.2%), pre-sellar 31 (6.2%), and conchal 16 (3.2%) types. The frequency of SSMD less than 1 mm, 1-3 mm, and greater than 3 mm was 40.6%, 38.4%, and 21.0%, respectively. An SEF was detected more frequently in females, while SSMD greater than 3 mm was more frequent in males. An FNM was more prevalent in the 18-29 and 30-39 age groups and SEF was significantly less frequent in patients over 60 years of age compared to other age groups. A sinus mucosa larger than 3 mm was more common in the younger than 18 year group. The frequency of post-sellar-type pneumatization was lower in patients younger than 18 years.
Conclusion
Skull-base anomalies are common and may be detected incidentally during imaging procedures. The sphenoid sinus, its variations, and pneumatization patterns should also be taken into consideration in imaging procedures performed for various purposes.

Keyword

Fossa navicularis magna; Canalis basilaris medianus; Sphenoid emissary foramen; Onodi cell; Sphenoid sinus

Figure

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  Fig. 1 Fossa navicularis magna and measurements (a: depth, b: length, c: width).

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  Fig. 2 Types of canalis basilaris medianus (arrows). A. Bifurcation. B. Inferior. C. Superior. D. Inferior recess. E. Superior recess. F. Channel type.

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  Fig. 3 A. Sphenoid emissary foramen and measurements (straight arrow: sphenoid emissary foramen, dashed arrow: foramen spinosum, arrowhead: foramen ovale; a: distance between sphenoid emissary foramen and midline, b: distance between sphenoid emissary foramen and foramen ovale, c: distance between sphenoid emissary foramen and foramen spinosum). B. Illustration of an Onodi cell (arrow).

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  Fig. 4 Sphenoid sinus mucosa and measurements (arrows). A. Sphenoid sinus mucosa dimensions (SSMD) less than 1 mm. B. SSMD 1-3 mm. C. SSMD greater than 3 mm.

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  Fig. 5 Sphenoid sinus pneumatization. A. Conchal. B. Pre-sellar. C. Sellar. D. Post-sellar.

Reference

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