The relevant anatomical parameters of the internal carotid artery and optic nerve in relation to lateral wall of sphenoid sinus-a MRI study
The relevant anatomical parameters of the internal carotid artery and optic nerve in relation to lateral wall of sphenoid sinus - a MRI study. Sphenoidal surgery and FESS surgery generally has low risk and complications rate. However the surgeries are technically challenging due to complex relati...
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| Main Author: | |
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| Format: | Thesis |
| Language: | English |
| Published: |
2013
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| Subjects: | |
| Online Access: | http://eprints.usm.my/56956/1/Suzieta%20bt%20Zamrah%20-%20e%2024.pdf |
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| Summary: | The relevant anatomical parameters of the internal carotid artery and optic
nerve in relation to lateral wall of sphenoid sinus - a MRI study. Sphenoidal surgery and FESS surgery generally has low risk and
complications rate. However the surgeries are technically challenging due to complex
relationship of neurovascular structures namely internal carotid artery (ICA) and
optic nerve . This study illustrates radiological anatomy relationship of the sphenoid
sinus with these neurovascular structures. To evaluate certain anatomical parameters of internal carotid artery
and optic nerve in relation to the lateral wall of sphenoid sinus based on modified
MRI protocol of pituitary gland. In this prospective study of 30 patients carried out from
December 2009 until August 2010, the following modified MRI protocols of pituitary
were performed. Sagittal, axial and coronal view in fat suppression sequences using
slice thickness of 1. 7 mm and spacing of 0.5 mm were performed. The smallest and
largest distance between both ICA were measured on coronal and axial views , and
their respective locations were determined for each patient. Indentations of optic
nerve or internal carotid artery on sphenoid sinus were also evaluated. Sphenoid sinus pneumatisation pattern was studied. Association between internal carotid artery
indentation with age, gender and types of sphenoid sinus pneumatisation were
determined. Most common type of sphenoid sinus pneumatisation was sellar type
(66.7%), followed by post sellar type (26.7%) and presellar type (6.7%). No concha!
type noted. The mean of smallest distance between right and left internal carotid
arteries were (7.00 ± 4.66 mm (coronal view) and 6.30 ± 4.70 mm (axial view); in
which majority (73.3%) located in cerebral/ supraclinoid segment and 26.7% in
cavernous. The mean of largest distances were 28.20 ± 5.90 mm (coronal view) and
28.43 ±5.7 mm (axial view). Of this, 46.7% located in cavernous segment, petrous
(40.0 %) and cerebral/supraclinoid (13.3%). Indentations of optic nerve and internal
carotid artery were noted in 46.7% and 66.7% of patients respectively. There was
significant association between type of sphenoid sinus pneumatisation with internal
carotid artery indentation ( p = 0.003). No statistically significant association between
internal carotid artery indentation with age and gender. Internal carotid artery and optic nerve indentations were noted in
46.7% and 66.7% of the patients respectively in our study. The smallest distance
between right and left internal carotid atiery can be as narrow as 6.30 mm, most
commonly located in the cerebral/supraclinoid segment. Both these anatomical
variants predispose the structures for injury and should be acknowledged to the
surgeon before the surgery. |
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