Welcome to International Journal of Anatomy and Research

Type of Article: Original Research

Year: 2016 | Volume 4 | Issue 2 | Page No. 2429-2433

Date of Publication: 30-06-2016

DOI: http://dx.doi.org/10.16965/ijar.2016.227

A COMPUTERIZED TOMOGRAPHIC STUDY OF MORPHOLOGY AND PNEUMATIZATION OF CRISTA GALLI

E. Kamala ¹, U. Vijaya Shanmugam ², T. S. Gugapriya ³, N. Vinay kumar ^*4.

¹ Assistant and Associate Professor, Department of Anatomy, Chennai Medical College Hospital & Research Centre, Tiruchirapalli, Tamilnadu, India.

² Associate Professor, Department of Ophthalmology, KAP Viswanatham Government Medical College, Tiruchirapalli, Tamilnadu, India.

³ Assistant and Associate Professor, Department of Anatomy, Chennai Medical College Hospital & Research Centre, Tiruchirapalli, Tamilnadu, India.

^*4 Associate Professor, Department of Anatomy, Government Medical College, Palakkad, Kerala, India.

Address: Dr. N. Vinay Kumar, Associate Professor, Department of Anatomy, Government Medical College, Palakkad, Kerala, India. Phone number: +919786630481
E-Mail: vinaydr1981@gmail.com

ABSTRACT

Introduction:  Asymmetrically divided sphenoid sinuses exhibits a variety of variation in the presentation of inter sinus septum. Previous reported range of incidence of single midline inter-sphenoid sinus septum is from 18.2% to 95%. Many studies have reported differing incidences of laterally placed septum, accessory septa, multiple septa, transverse septa and no septum in the sphenoid sinuses. Termination of inter-sphenoid septum either into internal carotid canal or into optic canal had also been shown in many studies with possibilities of high risk complications related to such termination of septum. As there exists only limited data in Indian ethnicity about the variations in presentation of inter-sphenoid sinus septum compounded by the relative high frequency of occurrence of endoscopic trans sphenoid microsurgeries, this study was done to observe variations occurring in septum of sphenoid sinuses.
Materials and Methods: A retrospective CT analysis of images obtained from 114 patients diagnosed with sinusitis during a specific study period was done by two independent observers. The age of the patients ranged from 16 - 60 years of both sexes. Patients with history of prior sinus or sphenoid surgery, facial trauma, obscured sphenoid sinus pathology were excluded.
Results: Single inter sphenoid sinus septum was seen in 83.3% .Out of this Midline, right deviation, left deviation were observed in 11.4%, 33.9% and 21.9% respectively. In 16.7 % images accessory/ multiple septum were noticed. While, absent inter sphenoid septum and transverse septum were noted each in 0.8% of images studied. The termination of inter sinus septum to internal carotid canal occurred in 27.3% and into optic canal in 48% of all images studied.
Conclusion: This study concluded that the variation in the presentation of inter-sphenoid septum and its termination at internal carotid artery canal or optic canal need to be pre operatively evaluated by surgeons for considering risk of septal resection during Trans-sphenoid endoscopic surgeries.
Key Words: Sphenoid Sinus, Septum, Inter-Sphenoid Septum, Paranasal Sinus.

REFERENCES

1. Som PM, Park EE, Naidich TP, Lawson W. Crista galli pneumatization is an extension of the adjacent frontal sinuses. Am J Neuro­radiol. 2009; 30:31-33.

2. Hajiioannou J, Owens D, Whittet HB. Evaluation of anatomical variation of the Crista galli using computed tomography. Clin Anat. 2010; 23:370-373.

3. Belden CJ, Mancuso AA, Kotzur IM. The developing anterior skull base: CT appearance from birth to 2 years of age. Am J Neuroradiol. 1997; 18:811-818.

4. Robinson M, Donlon D, Harrison H, Houang M, Stammberger H, Wolf G. Variations of the paranasal sinuses in Melanesians as ob­served by CT. Rhinology. 2010; 48:11-17.

5. Socher JA, Santos PG, Correa VC. Endoscopic surgery in the treatment of crista galli pneumatization evolving with localizated frontal headaches. Int Arch Otorhinolaryngol. 2013; 17(3):246–50.

6. Vital D, Holzmann D. Combined endoscopic approach to the crista galli for nasal dermal sinus cysts. J NeurolSurg B. 2012; 73: A006.

7. McLaughlin RB Jr, Rehl RM, Lanza DC. Clinically relevant frontal sinus anatomy and physiology. Otolaryngol Clin North Am. 2001; 34:1-22.

8. Wingate J, Rechtweg JS, Grand W, Jouandet M, Balos L, Wax MK. Mucocoele of the crista galli. J Otolaryngol. 2001; 30:43-46.

9. Mihail Dan Cobzeanu, VasilicaBaldea, MirceaCatalinBaldea, Patricia Sonia Vonica, Bogdan MihailCobzeanu. The anatomo-radiological study of unusual extra sinusal pneumatizations: superior and supreme turbinate, crista galli process, uncinate process. Rom J Morphol Embryol.2014; 55(3):1099–1104.

10. Lenon Jason D’Souza, Romina Geraldine D’Souza, Ram Shenoy Basti, Nikrish Hedge, H B Suresh. Morphometric evaluation of crista galli. International Journal of Recent Trends in Science and Technology. September 2015; 16(2):281-282.

11. Gorazd Poje, Ranko M ladina, Neven Stitarelic, Marcel Marjanovic Kavanaugh. Some radiological and clinical aspects of the sinus crista galli. Rom j Rhino.2014; 4(13):32-36.

12. Basic N, Basic V, Jukic T, et al. Computed tomographic imaging to determine the frequency of anatomical variations in pneumatization of the ethmoid bone. Eur Arch Otorhinolaryngol.1999; 256: 69-71.

13. Kim JJ, Cho JH, Choi JW, Lim HW, Song YJ, Choi SJ, Yeo NK. Morphologic analysis of crista galli using computed tomography. J Rhinol. 2012; 19(2): 91-95.

14. Al- Qudah M.A. - Anatomical Variations in Sino-Nasal Region: A Computer Tomography (CT) study. J Med J. 2010; 44(3):290-297.

E. Kamala, U. Vijaya Shanmugam, T. S. Gugapriya, N. Vinay kumar. A COMPUTERIZED TOMOGRAPHIC STUDY OF MORPHOLOGY AND PNEUMATIZATION OF CRISTA GALLI. Int J Anat Res 2016;4(2):2429-2433. DOI: 10.16965/ijar.2016.227