Patterns of Pneumatization of the Posterior Nasal Roof

• Published in: Tomography (Ann Arbor) Vol. 8; no. 1; pp. 316 - 328
• Main Authors: Mureșan, Alexandru Nicolae, Rusu, Mugurel Constantin, Rădoi, Petrinel Mugurel, Toader, Corneliu
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI 02.02.2022; MDPI AG
• Subjects: anterior cranial fossa; Cone-Beam Computed Tomography; cribriform plate; ethmoid bone; Ethmoid Bone - anatomy & histology; Ethmoid Bone - diagnostic imaging; Ethmoid Bone - surgery; Female; Humans; Male; Nasal Cavity - diagnostic imaging; paranasal sinuses; pneumatization; Retrospective Studies; Sphenoid Sinus; cribriform plate; pneumatization; ethmoid bone; anterior cranial fossa; paranasal sinuses; skull base; sphenoid sinus; nasal roof
• ISSN: 2379-139X; 2379-1381; 2379-139X
• DOI: 10.3390/tomography8010026

For good surgical performance, sound knowledge of anatomy is required. Although the ethmoid air cells and sphenoid sinuses are subject to a high degree of variation, their possible extensions above the nasal fossa at the posterior end of the cribriform plate of the ethmoid bone (CPEB) were seemingly overlooked. We retrospectively studied 162 case files from 55 male and 107 female cases, with ages varying from 42 to 80, which were scanned using Cone Beam Computed Tomography. In 56.17% of cases, an unpneumatized CPEB (type I) was found. Nasal roof recesses of ethmoidal origin (type II) were found at the posterior end of the CPEB in 20.37% of cases. Different types of sphenoidal pneumatizations of the posterior end of the CPEB (type III) were found in 22.83% of the cases. Onodi cells projected nasal roof recesses (type IV) in only 10 cases. In all types, nasal roof recesses were found either above the CPEB or within/underneath it. Moreover, such nasal roof recesses were found to be either unilateral, extended contralaterally, or bilateral. As such recesses of the posterior CPEB, previously overlooked, belong to the posterior rhinobase, they should be carefully documented preoperatively to avoid unwanted surgical damage to the olfactory bulb or CSF fistula.