Sphenoid sinus
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View Ayush Goel's current disclosuresAt the time the article was last revised Tariq Walizai had no financial relationships to ineligible companies to disclose.
View Tariq Walizai's current disclosures- Sphenoidal sinus
- Sphenoidal sinuses
- Sphenoid sinuses
- Sphenoid hemisinus
- Sphenoid hemisinuses
The sphenoid sinus is the most posterior paranasal sinus.
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Summary
location: the central body of the sphenoid bone anteroinferior to the sella turcica
blood supply: posterior ethmoidal and sphenopalatine arteries
innervation: posterior ethmoidal nerve and the orbital branch of the pterygopalatine ganglion
Gross anatomy
The sphenoid sinuses are paired spaces formed within the body of the sphenoid bone, communicating with the roof of the nasal cavity via the sphenoethmoidal recess in its anterior wall. The two hemisinuses are separated by a septum which may or may not be in the midline. It usually lies anteroinferior to the sella.
A large sinus can show a number of ridges and depressions related to closely adjacent structures. These can include the pituitary gland, optic nerve, and internal carotid artery.
Relations
superiorly: cavernous sinus, sella turcica, and its contents
inferiorly: nasal cavities
anteriorly: nasal cavities, posterior ethmoid air cells
posteriorly: contents of the middle cranial fossa
laterally: cavernous sinus, cranial cavity
Types of pneumatization
Pneumatization types have been subdivided 4:
conchal
lateral recess
presellar
sellar (which can be incomplete or complete)
Arterial supply
nasal branches of the sphenopalatine artery
Venous drainage
Lymphatic drainage
Lymphatic drainage occurs via afferent vessels leading into the retropharyngeal nodes
Innervation
parasympathetic: orbital branches of the pterygopalatine ganglion
sensory: posterior ethmoidal nerve from the nasociliary nerve, a branch of the ophthalmic division of the trigeminal nerve
Variant anatomy
With respect to optic nerve (CN II) relationship:
type 1: adjacent to sphenoid sinus
type 2: indenting the sinus
type 3: traversing the sinus
type 4: adjacent to posterior ethmoid sinus
Development
Pneumatization of the sphenoid sinus starts at around 2 years of age and it develops more slowly than the other paranasal sinuses.
Practical points
It is important to look for and report the type of pneumatization of this sinus and to report its relationship with adjacent neurovascular structures, especially the presence of dehiscence. In particular, the close proximity of the optic canal and carotid canal to the sphenoid sinus are important aspects to consider when planning sphenoid sinus surgery.5
See also
Quiz questions
References
- 1. Hamid O, El Fiky L, Hassan O et-al. Anatomic Variations of the Sphenoid Sinus and Their Impact on Trans-sphenoid Pituitary Surgery. Skull Base. 2008;18 (1): 9-15. doi:10.1055/s-2007-992764 - Free text at pubmed - Pubmed citation
- 2. Güldner C, Pistorius SM, Diogo I et-al. Analysis of pneumatization and neurovascular structures of the sphenoid sinus using cone-beam tomography (CBT). Acta Radiol. 2012;53 (2): 214-9. doi:10.1258/ar.2011.110381 - Pubmed citation
- 3. Mcminn. Last's Anatomy. ISBN: 9780729537520
- 4. Vaezi A, Cardenas E, Pinheiro-Neto C, Paluzzi A, Branstetter BF, Gardner PA, Snyderman CH, Fernandez-Miranda JC. Classification of sphenoid sinus pneumatization: relevance for endoscopic skull base surgery. (2015) The Laryngoscope. 125 (3): 577-81. doi:10.1002/lary.24989 - Pubmed
- 5. Asal N, Bayar Muluk N, Inal M, Şahan M, Doğan A, Arıkan O. Carotid Canal and Optic Canal at Sphenoid Sinus. Neurosurg Rev. 2018;42(2):519-29. doi:10.1007/s10143-018-0995-4 - Pubmed
Incoming Links
- Clival masses
- Sphenoidotomy
- Pituitary fossa
- Ethmoidal air cells
- Foramen rotundum
- Posterior ethmoidal foramen
- Transsphenoidal basilar skull fracture
- Transsphenoidal hypophysectomy
- Optic strut
- Juvenile nasopharyngeal angiofibroma
- Optic nerve
- Orbital nerve supply
- Skull (lateral view)
- Paranasal sinus mucocele
- Antrochoanal polyp
- Vomer
- Functional endoscopic sinus surgery preoperative variants (mnemonic)
- Allergic fungal sinusitis
- Ossifying fibromyxoid tumour
- Superior meatus
- Paranasal sinus development (Gray's illustration)
- Esthesioneuroblastoma
- Sinonasal nonkeratinizing squamous cell carcinoma
- Sinonasal angiomatous polyp
- Ecchordosis physaliphora
- Multifocal orbital and calvarial fractures
- Orbitotomy in Graves ophthalmopathy
- Large frontal osteoma
- Ocular staphyloma
- Arrested pneumatization of the sphenoid sinus
- Antrochoanal polyp
- Orbital subperiosteal abscess
- Sinonasal mucosal melanoma
- Blake's pouch cyst
- Widal syndrome
- Arachnoid cyst: extremely large
- Schneiderian papilloma
- Allergic fungal sinusitis
- Spheno-choanal polyp
- Chordoma - clivus
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