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Prevalence of accessory septations of sphenoid sinus in pediatric population: Applications to endoscopic sinus
Daniele Gibelli1, Michaela Cellina2, Stefano Gibelli3
1Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milan, Italy.
Insights
Accessory sphenoid septations, which can risk endoscopic sinus surgery, are common in children and do not significantly differ by age or sex. Their insertion onto the internal carotid artery (ICA) bone wall also occurs independently of age.
Area of Science:
- Otolaryngology
- Pediatric Radiology
- Anatomy
Background:
- Accessory sphenoid sinus septations pose a surgical risk, particularly during endoscopic procedures.
- Limited data exists on these anatomical variations in pediatric populations.
- Understanding these variations is crucial for surgical safety.
Purpose of the Study:
- To investigate the prevalence and characteristics of accessory sphenoid sinus septations in children.
- To assess the association of these septations with the internal carotid artery (ICA) bone wall.
- To determine the influence of age and sex on these anatomical variations.
Main Methods:
- Retrospective analysis of 220 pediatric maxillofacial CT scans (110 males, 110 females).
- Evaluation of septal prevalence, number of septations, and ICA bone wall insertion.
- Statistical analysis using Chi-square and Pearson's regression tests.
Main Results:
- Accessory septations were found in 66% of males and 71% of females, with no significant sex or age differences.
- Septal insertion onto the ICA bone wall occurred in 13% of subjects, independent of sex or age.
- The number of accessory septations showed a significant increase with age.
Conclusions:
- Accessory sphenoid sinus septations and their ICA bone wall insertion are common in children and similar to adult prevalence.
- These findings are vital for optimizing surgical planning and minimizing risks in pediatric endoscopic sinus surgery.
- Age and sex do not significantly impact the prevalence or ICA involvement of these septations.
Abstract:
Sphenoid sinus accessory septations and their possible insertion on internal carotid artery (ICA) may represent a risk for endoscopic sinus surgical procedures. However, scarce data on this variant for children are available so far. This retrospective study included 220 maxillofacial CT-scans equally divided among males (13.4 ± 2.1 years) and females (13.9 ± 2.2 years). On each CT-scan, prevalence of accessory septations, number of septations in sphenoid sinuses, and their possible insertion onto ICA bone walls were recorded. Significant differences in protrusion and insertion of septations onto the ICA bone walls according to sex were assessed through Chi-square test (p < .05). Possible correlations between the prevalence of accessory septations, ICA insertion, and number of accessory septations and age were assessed by means of Pearson's regression (p < .05). On average, 66% of males and 71% of females had at least one accessory septation, without significant differences according to sex or age (p > .05): septal insertion on ICA was found in 13% of subjects, without any significant difference for sex or age (p > .05). The number of septations was significantly increased with age (p < .05). The present study showed that the prevalence of accessory septations and insertion onto the ICA are independent of age and these results are similar to those reported in adults. Results will be useful for the management of endoscopic sinus surgery.
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