optic nerve canal relation to posterior paranasal sinuses in indian ethnics: review and objective classification
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2017
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Abstract
Introduction: Posterior paranasal sinuses consisting of posterior
ethmoid and sphenoid sinuses show varying pneumatization
and relationship to Optic Nerve Canal (ONC). Most commonly
ONC is superolateral to sphenoid sinus, however varied
protrusion of ONC into the sinuses may occur. Rarely it may
pass completely through the sinus. Optic Nerve (ON) is covered
by a thin bony layer or by periosteum and sinus mucosa without
bone. Extensive pneumatization of sphenoid sinus and bony
dehiscence predisposes to ON injury. The posterior ethmoid
cell namely the Onodi cell is of great surgical importance when
the ON is along its lateral wall and surrounds the nerve. These
varied relations imply that a detailed knowledge of the intimate
relationship of ONC with the posterior paranasal sinuses is
necessary to avoid unintentional complications during the
surgeries involving the ONC region.
Aim: To assess relationship of ONC to the posterior paranasal
sinuses in Indian Ethnic study group.
Materials and Methods: Retrospective review of 100
paranasal sinus Computed Tomography (CT) scans were done
using 64 row Multi Detector Computed Tomography (MDCT).
Multiplanar reformation images were assessed for ONC relation
to posterior ethmoid and sphenoid sinuses, wall dehiscence,
and Pneumatization of Anterior Clinoid Process (PACP).
Results: 200 optic nerve canals were assessed and grouped
into four types based on the modification of Delano et al.,
classification. The most common OCN was Type-1 (60%),
followed by Type-2 (15%), Type-3 (14%) and Type-4 (11%).
Dehiscence was seen in 35(17.5%) mostly in Type-3 canals.
PACP was seen in 30 (15%).
Conclusion: Knowledge of ON relationship to posterior
paranasal sinuses will reduce the devastating complications
during sinus surgeries. Our modified ONC classification is based
on the bony canal morphology and the degree of protrusion into
sinuses. As with other reported studies worldwide, Type-1 ONC
is the commonest among the Indians also. Type-2 and 3 ONC
with sinus wall dehiscence and PACP are the most important
anatomical variations which may potentially predispose to risk
of surgical injury to the optic nerves.
| Reference Key |
itagi2017journaloptic
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|---|---|
| Authors | ;RISHIKESH MADHUKAR ITAGI;CHAITRA PARAMESHWARA ADIGA;KIRAN KALENAHALLI;LAKSHMIKANTH GOOLAHALLY;MANJU GYANCHANDANI |
| Journal | JAMA network open |
| Year | 2017 |
| DOI |
10.7860/JCDR/2017/23447.9510
|
| URL | |
| Keywords | Keywords not found |
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