Incorporation of the sphenoid sinuses' septum / septa in the carotid canal - evaluation before the FESS.

2020 
The purpose of the research was to define the frequency prevalence of the incorporation of sphenoid sinuses' septum / septa in the carotid canal of the adult population. MATERIALS AND METHODS 296 computed tomography (CT) scans of the patients (147 females, 149 males), who did not present any pathology in the sphenoid sinuses, were evaluated in this retrospective analysis. Spiral CT scanner - Siemens Somatom Sensation 16 - was used to glean the medical images. Standard procedure applied in the option Siemens CARE Dose 4D. No contrast medium was administered. Multiplans reconstruction (MPR) tool was used in order to obtain frontal and sagittal planes from the transverse planes previously received. RESULTS Bilateral incorporation of the main septum (MS) in the carotid canal was not present in any of the patients, whereas unilateral incorporation was noticed in 21.96% of the patients (17.68% females, 26.17% males). On the right side it occurred in 11.82% of cases (10.88% females, 12.75% males), and on the left side in 10.14% of cases (6.8% females, 13.42% males). Bilateral incorporation of the additional septum (AS) was found in 8.45% of the patients (4.08% females, 12.75% males), whereas unilateral incorporation was noted in 28.37% of the patients. It was seen on the right side in 11.82% of cases (12.93% females, 10.74% males), and on the left side in 16.55% cases (15.65% females, 17.45% males). The most common variant was the incorporation of only one of the septa (either the MS or the AS) in the wall of the carotid canal unilaterally. Such situation took place in 30.07% of the patients (29.25% females, 30.87% males). Incorporation of two septa on the same side was noticed in 4.39% of cases (4.08% females, 4.7% males), and incorporation of three septa in 0.34% of cases (0.7% males). CONCLUSIONS The anatomy of the paranasal sinuses is varied to a great extent, hence performing a CT scan is crucial before the scheduled surgery, as it may lessen the unforeseeable surgical complications, that may result from the high prevalence of variants in the sinuses.
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