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Introduction: The varying pneumatisation patterns of the frontal sinus (FS) can be utilised in the forensic identification of human remains. This study aimed at determining the pneumatisation patterns of the FS of adult Nigerians. Materials and Methods: This descriptive cross-sectional retrospective study was carried out at the radiology department of a tertiary hospital in Nigeria following ethical approval. Brain computed tomography images of 336 patients (199 males and 137 females) aged ≥20 years were utilised. Images with facial and sinonasal pathologies were excluded from this study. The FS was evaluated and classified as either absent, bilateral or triple. The existence of complete or partial septa was noted, and the roof was categorised as either smooth or scalloped. Data were analysed using the Statistical Package for the Social Sciences version 23. The frequencies of each variant were presented in percentages. A Chi-square test was used to evaluate gender differences. P < 0.05 was considered statistically significant. Results: Bilateral FS was seen in 244 (72.6%) patients. This was followed by triple FS (48, 14.3%) and aplasia (44, 13.1%). The prevalence of partial septa was 197 (58.6%), with a significantly higher prevalence in males (149, 74.9%) than in females (48, 35.0%) (P = 0.017). The scalloped roof of the FS was more frequent (226, 67.3%) than the smooth FS roof (110, 32.7%), although both showed statistically significant gender differences (P = 0.021, 0.028). Conclusion: The scalloped roof and partial septa of the FS showed sexual dimorphism. Hence, their accuracy in sex prediction may be explored in our population.

Introduction: The sphenoid sinus is considered to be morphologically one of the most variable structures in the human body. Aim: The aim of this study was to analyse the variants of pneumatisation of sphenoid bone and to determine differences in relation to the gender and body side in the population of Vojvodina. Material and methods: This retrospective study included 60 patients (30 males and 30 females), mean age 39.92 years, who underwent a CT scan of paranasal sinuses in the Center of Radiology, Clinical Center of Vojvodina, Novi Sad. The total number of analysed sinuses was 120. The CT scan images were presented in coronal, sagittal and axial planes. The types and the extensions of sinus were analysed. Results: The most common type of the sphenoid sinus was sellar (83.33%), followed by presellar (15.83%). The conchal type was found in only one case (0.83%). The most frequent subtype of the posterior extension in males was subdorsal (48%) and in females subtype body (42%). The presence of both lateral and anterior extensions was found in 18.33% cases, only lateral extension in 45% cases and only anterior in 10%. Conclusion: The most common type of sphenoid sinus was sellar, while the conchal type was the rarest one. The most frequent subtype was subdorsal in males and subtype body in females. The lateral extension was observed more often in comparison to the anterior extension.

WOS: 000484118100022 PubMed ID: 30664229 Background: Pneumatisation of the inferior turbinate (PIT) is a rare abnormality of the paranasal sinus. It is very difficult to differentiate from the hypertrophia of the inferior turbinate clinically. Thus, it is important to be considered, especially in cases with no response to medical treatments. We aimed to investigate the presence and the frequency of PIT by computed tomography (CT). Materials and methods: A total of 2905 cases (1381 female, 1524 male) with an age range between 16 and 84 were included. Results: The pneumatisation of the inferior turbinate was observed in 1.72% of the cases with a percentage of 1.88% in women and 1.57% in men. In PIT (+) cases the bilaterality was found in 54% of them. According to the subtypes, 70% was lamellar, 28% was bullous and 2% was extensive. No statistically significant difference was found for age distribution. The most commonly associated variations were the pneumatisation of the middle and upper turbinate and the septal deviation. Conclusions: The pneumatisation of the inferior turbinate is a rare variation with a similar frequency among men and women. It is diagnosed by CT and when symptomatic the optimal treatment is surgery.

Purpose: Assessment of sphenoid sinus (SS), posterior clinoid process (PCP), and dorsum sellae (DS) pneumatisation is significant when planning surgical approaches both to intra- and extrasellar pathologies. The authors analysed pneumatisation of the SS, with particular attention paid to pneumatisation of the PCP and DS. Material and methods: The study was based on 100 computed tomography angiography examinations. SS, PCP, and DS pneumatisation grades were assessed using the classification system proposed by Hardy. The analyses were conducted in sagittal planes: midline plane (MP), sagittal posterior clinoid plane right (SPCP-R), and sagittal posterior clinoid plane left (SPCP-L). The occurrence of the highest pneumatisation grade (IVB according to Hardy), which encompasses DS and PCP, prompted the authors to conduct a further analysis in the coronal plane. In this way, seven DS and PCP pneumatisation symmetry types were identified. Results: In the MP and SPCP-R, the most frequent pneumatisation grade was grade III (41% and 38%, respectively). In the SPCP-L, grade IVA prevailed (41%). Grade IVB was found in 12% of the SPCP-R images, 10% of the SPCP-L images, and in 12% of the MP images. Consistent pneumatisation grades in all analysed planes were found for 64% of cases. This was usually grade III noted in 28% of cases. Conclusions: SS pneumatisation is characterised by considerable individual variability. There are a number of SS pneumatisation classification systems, but the system proposed by Hardy is the most useful for assessment of DS and PCP pneumatisation. Grade III of SS pneumatisation is the most common. Pneumatisation encompassing DS and PCP was found in 10-12% of cases.

INAL, MIKAIL/0000-0003-0642-7913 WOS: 000467137500032 PubMed: 29926302 In the present study, we investigated the relationship between sphenoid sinus, carotid canal, and optic canal on paranasal sinus computed tomography (PNSCT). This study was performed retrospectively. PNSCT images of 300 adult subjects (159 male, 141 female). Sphenoid sinus (pneumatisation, dominancy, septation, inter-sinus septa deviation), anterior clinoid process pneumatisation, Onodi cell, carotid and optic canals (width, dehiscence, classification) were measured. In males, type 3 pneumatised sphenoid sinus (in both sides) and in females type 2 pneumatised sphenoid sinus (right side) and type 3 pneumatised sphenoid sinus (left side) were detected more. Anterior clinoid pneumatisation was present 47.2% in males and 39.7% in females. In male group, more septation (i.e. 22.6%, 3 septa) in sphenoid sinus were detected. Onodi cell was present 26.6 and 19.1% in males and females, respectively. Carotid canal protrudation to the sphenoid sinus wall was present 23.9-32.1% in males and 35.5-36.2% in females. Dehiscence in carotid canal was detected more in females (34%) compared to males (22%). Optic canal protrudation was 33.3 and 30.5% in males and females. Type 4 optic canal was detected more in both gender. Optic canal dehiscence was detected 11.3 and 9.9% in males and females. Carotid and optic canal diameters were higher in males. In pneumatised sphenoid sinuses and in females, type 3 carotid canal (Protrudation to SS wall) (bilaterally) and type 1 optic canal type (No indentation) (ipsilateral side) were detected more. In elderly patients, carotid and optic canal width increased. When carotid canal protrudation was detected, there was no indentation in optic canals In pneumatised SS, carotid canal protrudation was observed with a greater risk in surgery. However, type 1 (non indentation) optic canal was present in highly pneumatised SS with lower risk for the surgery. In women, the risk of carotid canal protruding (about 1/3) is greater than that of males, and carotid canal dehiscence rates are also higher in females. Therefore, physicians should be very careful during the preparatory stages of the sphenoid sinus surgery. Otherwise, it may not be possible to prevent lethal carotid artery bleeds.

WOS: 000444193000022, PubMed ID: 29399752, Background: The anterior clinoid process (ACP) is usually removed during surgical procedures of the cellar region. The ACP may be different length and width in people; it may be also pneumatic. Therefore, we aimed to determine dimensions and rates of pneumatisation of the ACP in the large study group with clinically importance. Materials and methods: One thousand and thirty-one (592 female, 439 male) cranial computed tomography (CT) of the middle Anatolian population was used in this study. The length and basal width of the ACP were measured on the cranial CT. Also; incidence and degree of ACP pneumatisation were identified. Results: The width of the right and left ACPs in females were 10.80 +/- 2.27 mm and 10.53 +/- 2.07 mm, respectively. The width of the right and left ACPs in males were 11.08 +/- 2.39 mm and 10.98 +/- 2.35 mm, respectively. The length of the right and left ACPs in females were 8.32 +/- 2.40 mm and 8.34 +/- 2.35 mm, respectively. The length of the right and left ACPs in males were 8.87 +/- 2.62 mm and 8.93 +/- 2.64 mm, respectively. There was statistically significant difference between males and females in ACP dimensions, except for the width of the right ACP. Pneumatisation of the ACP was observed on the right side in 46 (9.3%) cases, on the left side in 53 (10.6%) cases, and bilaterally in 32 (6.5%) cases. Incidence of pneumatisation of the ACP was decreased in the age group of 1 month to 20 years. While the incidence of bilateral pneumatisation of the ACP was higher in individuals aged 21-40. Conclusions: Radiologically recognising pneumatisation and anatomical variations of the ACP may be helpful in decreasing the incidence of surgical complications during anterior clinoidectomy.

Aims and Objectives: The aim of this prospective clinical study was to evaluate the success of one-stage direct (lateral) sinus lift procedure in severely atrophic posterior maxilla. Materials and Methods: One-stage direct (lateral) sinus lift procedure was carried out at 15 sites in 13 patients. All patients included in the study presented with partially edentulous posterior maxilla with one or more missing teeth and residual bone height less than 5 mm. Three months after surgery, patients were evaluated to access increase in residual bone height, density of new bone formed and implant stability. Patients were also evaluated after 3 months of prosthetic placement for the success of implant-supported prosthesis. Results: At 3 months post-operatively, increase in residual bone height was 8.31 ± 1.63 mm and the mean density of the newly formed bone around the implants was 417 ± 66.61 HU. All implants were stable and successfully osseointegrated, except one implant that was lost. The success rate of implant stability was 96.3% during the study period. Conclusion: Single-stage direct (lateral) maxillary sinus floor augmentation is a good treatment option with predictable outcome for patients with deficient alveolar bone in posterior maxilla.

OBJECTIVE: The posterior most among the paranasal sinuses, the sphenoid sinuses exhibit high variability in their structure, pneumatisation and relation to surrounding neurovascular structures. The protrusion of optic nerve (ON) into the superolateral wall of the sinus has been reported in literature wit h varied incidence. The pneumatisation of sphenoid sinus and its extension to anterior clinoid process (ACP) is also been mentioned in few studies. The variability in the incidence and the inconsistency in the association between optic nerve protrusion and degree of pneumatisation seen in studies done in different ethnicity and with paucity of Indian studies necessitated this study on positional variation of optic nerve in relation to sphenoid sinuses and its association with pneumatisation of anterior clin oid process in South Indian ethnicity. THE METHODS: CT scan images in coronal section collected from 114 patients with sinusitis with in the age group of 16 - 64 years belonging to both sexes were studied. The CT images were evaluated for the position of ON with sphenoid sinuses, protrusion of it into the sinus walls, bony dehiscence, pneumatisation of ACP. The position of ON was classified into Delano’s four types and their incidence noted. RESULTS: Type 1 position of ON was observed predominantly in 65.8% s ides while Type 2, 3, 4 were seen in 29.8%, 1.8% and 2.6% sides respectively out of 228 sides studied. Associated bony dehiscence was noted in only 5 out of 228sides (2.1%) studied. The pneumatisation of ACP was observed in 23.6% of the CT scans studied. T he association between ON protrusion and ACP pneumatisation was found to be statistically significant with P= 0.008 . CONCLUSION: The varying position of ON, its protrusion with or without dehiscence in to the sphenoid sinus wall with statistically signific ant association with ACP pneumatisation in south Indian ethnicity warrants a systematic CT evaluation pre operatively to ensure efficient surgery with minimal complications.