Abstract

Özet Amaç: Sfenoid sinüste yer alan septum, optik sinir ve internal karotid arter ile ilgili olarak varyatif durumlar›n belirlenmesi. Yöntem: Akut/kronik sinüzit tan›s›yla paranasal sinüs bilgisayarl› tomografi istenen 218 hasta retrospektif olarak taranm›flt›r. Bu hastalar›n tomografileri aksiyel ve koronal kesitlerde incelenerek sfenoid sinüs, kemik septa varyasyonlar›, say› ve uzan›m flekli yönünden s›n›f-land›r›lm›fl, ayr›ca optik sinir ve internal karotid arter protrüzyon valanslar› hesaplanm›flt›r. Bulgular: Radyolojik inceleme sonucunda 5 tip septa varyasyonu saptanm›flt›r. Yüz otuz iki adet (%60,5) tek komplet septumlu, 66 adet (%30.2) tek inkomplet septumlu, 6 adet (%2.7) çift septumlu (komplet+inkomplet), 9 adet (%4.1) çift septumlu (komplet+komplet) ve 5 adet (%2.2) septumu olmayan sfenoid sinüs tan›mlanm›flt›r. Tek olan septumlar›n %64 oran›nda orta hatta oldu¤u, di¤er tiplerin ise orta hatt›n hemen sa¤ veya solundan bafllad›¤› izlenmifltir. Ayr›ca optik sinir ve internal karotid arter protruzyon oranlar› (n=39) 17.8% ve (n=61) %27.9 olarak bulunmufltur. Sonuç: Cerrahi öncesi bilgisayarl› tomografi ile yap›lan de¤erlendir-me ve cerrahi planlama, endoskopik giriflimler için çok büyük önem tafl›makta ve olas› majör cerrahi komplikasyonlar›n azalt›lmas›nda rol almaktad›r. Anahtar sözcükler: Endoskopik sinüs cerrahisi, sfenoid sinüs varyasyonlar›. Abstract Objective: To determine septal variations and rates of intrasinusal protrusions of optic nerve and internal carotid artery in sphenoid sinus. Methods: Retrospective analysis of spiral computed tomography scanning of paranasal sinuses of 218 patients diagnosed as acute/chronic sinusitis was performed. Bilateral sphenoid sinuses were evaluated as if a single sinus, septa of this sinus were evaluated in terms of number and configuration. Besides rates of optic nerve and internal carotid artery protrusions were determined. Results: A total of 5 types of septal variations were detected. A single complete septum (n=132; 60.5%), a single incomplete septum (n=66; 30.2%), double septum (complete + incomplete, n=6; 2.7%), two complete septa (n=9; 4.1%), and sphenoid sinuses without septum (n=5; 2.2%) were identified. Sixty-four percent of single septum was located in midline, while other types were found immediately right or left side of the midline. Besides, protrusions of optic nerve and internal carotid artery were detected in 39 (17.8%) and 61 (27.9%) cases, respectively. Conclusion: Preoperative evaluation with computed tomography and surgical planning dependent on these findings are very important for endoscopic interventions and these approaches minimize potential major intraoperative complications.