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The sphenoid sinus during childhood: establishment of normal developmental standards by MRI
D Szolar1, K Preidler, G Ranner
1Department of Radiology, Karl Franzens University Hospital, Graz, Austria.
Insights
This study establishes normal developmental standards for the pediatric sphenoid sinus using MRI. Findings provide a reference for diagnosing developmental abnormalities in children.
Area of Science:
- Pediatric Radiology
- Craniofacial Development
- Medical Imaging
Background:
- The sphenoid sinus is crucial for craniofacial development.
- Understanding its normal growth is essential for diagnosing pediatric conditions.
- Limited data exists on age-related sphenoid sinus development in children.
Purpose of the Study:
- To establish baseline standards for normal age-related sphenoid sinus development in children.
- To evaluate bone marrow conversion, pneumatization, enlargement, and septation.
- To provide a reference for diagnosing sphenoid sinus abnormalities.
Main Methods:
- Retrospective review of 401 pediatric patients (<15 years) undergoing MRI.
- Evaluation of T1-weighted sagittal and T2-weighted axial scans.
- Assessment of bone marrow conversion, pneumatization, enlargement, and septation.
Main Results:
- Sphenoid sinus shows low signal intensity (red bone marrow) until 4 months.
- Pneumatization begins around 13-15 months, reaching 85% by 48 months.
- Complete pneumatization by age 10; enlargement follows a specific profile; septation varies.
Conclusions:
- This study provides crucial reference standards for normal sphenoid sinus development.
- Recognizing these developmental patterns aids in diagnosing and managing pediatric sinonasal conditions.
- Findings are valuable for pediatric radiologists and clinicians managing sinonasal pathologies.
Abstract:
To obtain baseline standards of normal age-related development of the sphenoid sinus during childhood magnetic resonance images of the sphenoid sinus in 401 patients less than 15 years old were reviewed. T1-weighted sagittal and T2-weighted axial scans were evaluated for bone marrow conversion, development of pneumatization, spatial enlargement and septation of the sphenoid sinus. The sphenoid sinus had a uniformly low signal intensity (red bone marrow) on T1-weighted images in all children less than 4 months old. Signal intensity changes from hypo- to hyperintense (bone marrow conversion) started at age of 4 months. Onset of pneumatization was observed in 12% of the patients at age 13-15 months. By age 43-48 months, 85% of the patients showed pneumatization of the anterior part of the sphenoid bone. Pneumatization was complete in all patients older than 10 years. Enlargement of the sinus showed a characteristic profile in each dimension. Median septation was observed irregularly with age, with a maximum of 77%. Septum variants were noticed between 4.5% and 20%. The recognition of this phenomenon may serve as a reference for evaluating normal and abnormal development of the sphenoid sinus and may be of great value for diagnostic and therapeutic management of pathologic conditions of the child's sphenoid sinus and its surrounds.