Neurovascular Surgical Keys Related to Sphenoid Window: Radiologic Study of Egyptian's Sphenoid

The anatomic variations of the sphenoid sinus and its relation to the surrounding neurovascular structures are a subject of interest. The purpose of this study was to radiologically assess the frequency of protrusion/dehiscence of key neurovascular landmarks surrounding the Egyptians' sphenoid.

This is a cross-sectional descriptive study of sinonasal computed tomography of the sphenoid sinus in 500 adult Egyptians, conducted at Mansoura University Hospitals; Egypt, over a period of 1 year. Two archives were used for collecting the data; the hard archive and the electronic archive. Variables of interest included the extent of sphenoid sinus pneumatization; intersphenoid septation pattern; protrusion/dehiscence of the internal carotid artery, optic nerve, maxillary nerve, and vidian nerve; and detection of the Onodi cell.

Population of this study included 265 women and 235 men. Their ages ranged from 18-68 years. The bilateral sellar-type pneumatization was shown as the most common pneumatization type (96.8%). Pneumatizations of the pterygoid process, anterior clinoid process, and greater wing of the sphenoid were identified in 9.3%, 8.9%, and 31.8% consequently. A single intersphenoid septum was detected in 85.2%, whereas multiple intersphenoid septums were noted in 11.6%. Protrusion of the internal carotid artery, optic nerve, vidian nerve, and maxillary nerve was recorded in 8.5%, 9.1%, 6.6%, and 3.4% consequently, while dehiscence was reported in 7.2%, 15%, 11.9%, and 4.2% consequently as well. Onodi cell was recognized in 18%.

This radiologic study highlights significant variations of surgically important anatomic structures related to the sphenoid sinus in Egyptians.