Morphology of middle septum and accessory septum of the sphenoid sinus
Korean Journal of Otorhinolaryngology-Head and Neck Surgery (대한이비인후과학회지 두경부외과학)
Korean Journal of Otorhinolaryngology-Head and Neck Surgery (대한이비인후과학회지 두경부외과학), Vol.44(2) : 153~156, 2001
Background and Objective : Sphenoid sinus has a midline septum. In the previous study using Korean cadaveric heads, we found various patterns of midline septum and another septum called accessory septum. This study aimed to investigate the surgical anatomy and clinical applications of midline septum and the accessory septum of the sphenoid sunus. Material and Method : One hundred sagittally-divided adult cadaveric heads were used. After removing the sinus mucosa meticulously, careful examination and photodocumentation were conducted serially. We analyzed the location of the accessory septum and its relationship with the bulging of neurovascular structures. Prior to dissection, axial plane CT were taken from 31 adult cadaveric heads and we examined the patterns of midline septum. Result : The most prevalent pattern of midline septum was that its anterior part was the midline, while posterior part was deviated to one side(61.3%) and connected to the bulging of the segment 1 of the internal carotid artery(23%). The most prevalent pattern of accessory septum was that the lateral sagittal septum (38%) was connected to the bulging of the segment 1, 3 of the internal carotid artery or the optic canal (53%, 42% and 11%, respectively). Conclusion : There are may kinds of patterns of midline and accessory septums in the sphenoid sinus. The midline septum is not a midline indicator of the skull base. It is necessary that surgeon is careful while removing the midline septum and the accessory septum in the sphenoid sinus since they are connected to neurovascular structures.