Related Experiment Video
Updated: May 24, 2026
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Sphenoid sinus septations: unpredictable anatomic landmarks in endoscopic pituitary surgery
Justin Poirier1, Neil Duggal, Donald Lee
1Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, ON.
Summary
Sphenoid sinus septations are not reliable surgical landmarks for identifying the internal carotid artery prominence. This study found only 17% of septations inserted at the artery, contradicting previous literature.
Area of Science:
- Otolaryngology
- Neurosurgery
- Radiology
Background:
- Sphenoid sinus septations are anatomical variations within the sphenoid sinus.
- Accurate identification of the internal carotid artery (ICA) is crucial during endoscopic sinus surgery.
- Previous studies suggested sphenoid sinus septations could serve as landmarks for the ICA.
Purpose of the Study:
- To evaluate the reliability of sphenoid sinus septations as predictable landmarks for the internal carotid artery prominence.
- To assess the relationship between sphenoid sinus septations and ICA location in patients undergoing pituitary tumor resection.
Main Methods:
- Analysis of 56 preoperative high-resolution computed tomographic (HRCT) scans.
- Identification and counting of sphenoid sinus septations.
- Evaluation of septation termination locations relative to the internal carotid artery prominence.
Main Results:
- A mean of 1.57 septations per sphenoid sinus was observed.
- Out of 88 analyzed septations, only 17% inserted at the internal carotid artery prominence.
- Significant variability in septation insertion points was noted.
Conclusions:
- Sphenoid sinus septations cannot be reliably used as surgical landmarks to predict internal carotid artery location.
- Findings contrast with existing literature, highlighting the need for caution in surgical planning.
- Further research may be needed to identify consistent landmarks for the ICA in this region.
Related Concept Videos
01:17The Pituitary Gland
The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
01:27Cranial Bones: Lateral View
The lateral view of the cranium is dominated by temporal, sphenoid, and ethmoid bones.
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...