| Objective: The volumes of maxillary sinus, sphenoid sinus, and mastoid cells were studied and compared in the rhinosinusitis or otitis media patients and controls. the frequency of internal carotid artery and optic nerve prominent in sphenoid sinus were observed and it was analysed that the relation between frequency of internal carotid artery prominent and volumes of sphenoid sinus. Based on those findings, we studied the relations among sinusitis, otitis media, and skull bone pneumatization and the pneumatization relations between paranasal sinuses and mastoid cells. It was searched that the rule between the appearance frequency of the internal carotid artery prominen and sphenoid sinus volumes and the principles to protect optic nerve in the operations via the path of sphenoid sinus.Methods: Data collection: 30 sinusitis patients, 15 otitis media patients, and 350 subjects without any abnormality (as normal controls) were found in this study. GE helix CT was used for successive scanning CT (64 row / 128 layer). The scan line was parallel to canthomeatal line (OML), the layer of paranasal sinus was 3.75 mm and the layer of middle ea疤?s 2.50 mm. And reconstruct image in ??layer of 1 mm at horizontal plane and coronal Plane, after that reconstructed image was record the in CD-ROM and transferred into other computer for analysis.2.Data analysis: The incidences of bulge of internal carotid artery and optic nerve in sphenoidal sinus were observed and recorded at horizontal plane and coronal section on the images of 350 control subjects. The maxillary sinus,sphenoid sinus and mastoid cells were sketched using a semiautomatic method and their volumes were calculated in reconstructive model with Mimics 12.0 3D- image processing software.Results: 1.The volumes of maxillary sinus and sphenoid sinus in the sinusitis were 7.01±2.86 cm3 and 4.80±1.20 cm3, while in the control group were 30.17±13.54 cm3 and 17.79±6.93 cm3 . The volumes of mastoid cell in otitis media was 7.48±3.43 cm3, as in the control group was 13.09±6.31 cm3; The result of volume of maxillary sinus, sphenoid sinus between sinusitis group and control group had no statistic difference while that of otitis medial and control group had significant difference. To evaluate the dependability between paranasal sinus and mastoid cells in the control group, we concluded the no significant difference between maxillary, sphenoid sinus and mastoid cells.2. He results of relation between the extent of sphenoid pneumatolysis and sphenoid protuberance in 350 subjects were:疤?subjects (70.75%) had no internal carotid a??y protuberance in sphenoid sinus; 31 subjects had one protuberance in sphenoid sinus (17 subjects with minor protuberanc, and the other 14 with significant protuberanc) reaching to 8.49%. There were also 108 subjects (20.74%) of two-sided protuberance (31 subjects with one-sided minor protuberanc, 29 subjects with two-sided minor protuberanc and 48 ones of two-sided significant protuberanc). So the percentage of internal carotid artery protuberance in the sphenoid sinus was 29.25%. Based on above results, subjects were classified into three groups: Group 1 of no internal carotid artery protuberance, Group 2 of one-sided internal carotid artery protuberance and Goup 3 of two-sided internal carotid artery protuberance. We measured the volumes of sphenoid sinus of 30 subjects selecting from each group at random and analyse the relation between protuberance and the volume of sphenoid. The volume of no internal carotid artery protuberance was 11.16±16.00 (8.57～14.67) cm3; that of one-sided internal carotid artery protuberance was 14.20±1.80 (11.76～20.86) cm3, and that of two-sided internal carotid artery protuberance was 25.03±2.21 (18.37-31.24) cm3.3.There were two types of the pathway of optic nerve and clinical means: one with no optic canal bulge in no pneumatization sphenoid sinus but adjacent to optic nerve; the other one with optic canal bulge of 14% subjects in well pneumatolysis sphenoid sinus, in the lateral wall of sphenoid sinus, eve疤? exposed in the ntracavitary. When us??transsphenoidal approach, be careful to adjacent optic nerve otherwise there would be severe complication.4. When the internal carotid artery passed through the sphenoid sinus, there was an elevationin or a half canal intrusion or the whole canal intrusion to the sphenoid sinus of well pneumatolysis. There was a thin bone or no bone between the blood vessel and sphenoid sinus. The blood vessels were exposed in the sphenoid sinus when there was no bone. The bone was thick when there is no elevation.Conclusion: 1. There was no association between the incidence of sinusitis and the pneumatolysis of sinus paranasales. There was a significant association between the incidence of otitis media and pneumatolysis of mastoid cells, the incidence was higher in lower pneumatization.2.There was a significant association between the pneumatization degree of sphenoid sinus and elevation of internal carotid artery, the higher incidence of elevation of internal carotid artery when the bigger volume. we need to choose the operation method based on the pneumatization of sphenoid sinus.3.There was also a significant association between degree of sphenoid sinus and elevation of optic never canal. The elevation of optic never canal was concomitance with the better degree of pneumatization of sphenoid sinus and go with elevation of internal carotid artery. Sometimes the optic ne疤?was exposed, sometimes a part of optic nerve was located in the lateral wall of sphenoid sinus. |
