Araştırma Makalesi
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Prevalence of Pterygoid Process Pneumatization, Distribution of Anterior Skull Base Depth, and Their Correlation

Yıl 2025, Cilt: 10 Sayı: 2, 37 - 42, 31.08.2025
https://doi.org/10.55694/jamer.1649924

Öz

Aim: Prior to functional endoscopic sinus surgery (FESS), Paranasal Sinus Computed Tomography (PSCT) is
routinely performed to assess anatomical structures and variations in detail. Numerous studies have investigated
the relationships between anatomical structures in the paranasal region. This study aims to evaluate the impact of
pterygoid process pneumatization (PPP) on the depth of the olfactory sulcus and the anterior skull base (ASB) in the
Turkish population.
Materials and Methods: PSCT images of 460 patients aged 18 years and older were retrospectively analyzed. PPP
and ASB depth were evaluated separately for the right and left sides using the Keros classification. The association
between PPP and ASB depth, as well as its impact on the Keros classification, was statistically assessed.
Results: A total of 460 patients were included in the study, comprising 222 males (48.3%) and 238 females (51.7%),
based on PSCT images. According to the Keros classification, a similar distribution was observed between the right
and left sides, with Type 2 being the most prevalent (54.1%), followed by Type 1 (28.3%), while Type 3 (17.6%) was the
least frequent. PPP was identified in 40.7% of cases on the right side, 42.2% on the left side, and 39.1% bilaterally.
Statistical analysis revealed no significant association between PPP and Keros classification.
Conclusion: Our study demonstrated that PPP was present in 42.2% of cases on the left side, with Keros Type 2
being the most common classification. No significant correlation was found between PPP and ASB depth, suggesting
that PPP does not influence the depth of the anterior skull base.

Etik Beyan

Ankara Bilkent City Hospital, TABED-1-25-914/15.01.2025

Destekleyen Kurum

The study did not receive funding.

Kaynakça

  • 1. Karatay E, Avcı H. Evaluation of olfactory fossa anatomy by computed tomography and the place of Keros classification in functional endoscopic sinus surgery. South Clin Istanb Eurasia. 2021; 32 (1): 47-52.
  • 2. Vemuri NV, Karanam LSP, Manchikanti V, Dandamudi S, Puvvada SK, Vemuri VK. Imaging review of cerebrospinal fluid leaks. Indian J Radiol Imaging. 2017;27:441–446.
  • 3. Çufalı ŞA, Çetin MA, Kum NY, Karakurt SE. The Effects of Nasal Septal Deviation on Anterior Skull Base Parameters. Int Arch Otorhinolaryngol. 2024;28:e394–399.
  • 4. Reddy UDMA, Dev B. Pictorial essay: Anatomical variations of paranasal sinuses on multidetector computed tomographyHow does it help FESS surgeons? Indian J Radiol Imaging. 2012;22:317-324.
  • 5. Yousuf M, Jamil A, Hashmi Q, Hameed K, Sami M, Shaikh T, et al. Anatomical variation of the olfactory fossa according to keros and yenigun classifications in karachi, pakistan. Cureus. 2024;16:e73314.
  • 6. Erdogan S, Keskin G, Topdag M, Ozturk M, Sari F, Mutlu F. Ethmoid roof radiology; analysis of lateral lamella of cribriform plate. Otolaryngol Pol. 2015;69:31–36. https://doi. org/10.5604/00306657.1184543.
  • 7. Ulualp SO. Complications of endoscopic sinus surgery: appropriate management of complications. Curr Opin Otolaryngol Head Neck Surg. 2008;16:252–259.
  • 8. Degaga TK, Zenebe AM, Wirtu AT, Woldehawariat TD, Dellie ST, Gemechu JM. Anatomographic variants of sphenoid sinus in ethiopian population. Diagnostics (Basel). 2020;10 (11):970
  • 9. Aijaz A, Ahmed H, Fahmi S, Samreen T, Rasheed B, Jabeen H, et al. A comprehensive computed tomographic analysis of pneumatization pattern of sphenoid sinus and their association with protrusion/dehiscence of vital neurovascular structure in a pakistani subgroup. Turk Neurosurg. 2023;33(3):501-508.
  • 10. Ominde BS, Ikubor J, Igbigbi PS. Pneumatization patterns of the sphenoid sinus in adult nigerians and their clinical implications. Ethiop J Health Sci. 2021;31:1295.
  • 11. Kusch AM, Ruiz García V. Giant pneumatization of sphenoid sinus: Report of four cases and review of literature. Revista Médica Herediana. 2019;30:45.
  • 12. Sagar S, Jahan S, Kashyap SK. Prevalence of anatomical variations of sphenoid sinus and its adjacent structures pneumatization and its significance: A CT scan study. Indian J Otolaryngol Head Neck Surg. 2023;75:2979–2989.
  • 13. Keros P. On the practical value of differences in the level of the lamina cribrosa of the ethmoid. Z Laryngol Rhinol Otol. 1962;41:809-813.
  • 14. Krmpotić-Nemanić J, Vinter I, Judaš M. Transformation of the shape of the ethmoid bone during the course of life. Eur Arch Otorhinolaryngol. 1997;254:347–349.
  • 15. Birkin T, Acar T, Esen Ö. Sinonazal bölge anatomik varyasyonları ve sinüs hastalıkları ile olan ilişkisi. The Journal of Tepecik Education and Research Hospital. 2017;27:236–242.
  • 16. Güngör G. Evaluation of the variations of paranasal sinuses by computed tomography. Haydarpasa Numune Med J. 2019; 59(4): 320-327.
  • 17. Fatihoglu E, Aydin S, Karavas E, Kantarci M. The pneumatization of the sphenoid sinus, its variations and relations with surrounding neurovascular anatomic structures: A computerized tomography study. Am J Otolaryngol. 2021;42 (4):102958.
  • 18. Rahmati A, Ghafari R, Anjomshoa M. Normal variations of sphenoid sinus and the adjacent structures detected in cone beam computed tomography. J Dent Shiraz Univ Med Sci. 2016; 17(1): 32-37.
  • 19. Aijaz A, Ahmed H, Fahmi S, Samreen T, Rasheed B, Jabeen H. A Comprehensive computed tomographic analysis of pneumatization pattern of sphenoid sinus and their association with protrusion/dehiscence of vital neurovascular structure in a pakistani subgroup. Turk Neurosurg. 2023;33:501–508.
  • 20. Turkdogan FT, Turkdogan KA, Dogan M, Atalar MH. Assessment of sphenoid sinus related anatomic variations with computed tomography. Pan Afr Med J 2017;27:109.
  • 21. Kazkayasi M. Anatomic variations of the sphenoid sinus on computed tomography. Rhinology Journal 2025;43:109–114.
  • 22. Lakshman N, Viveka S, Thondupadath Assanar FB. Anatomical relationship of pterygoid process pneumatization and vidian canal. Braz J Otorhinolaryngol. 2022;88:303–308.

Pterygoid Process Pnömotizasyonunun Sıklığı, Anterior Kafa Tabanı Derinliğinin Dağılımı ve Birbiriyle Korelasyonu

Yıl 2025, Cilt: 10 Sayı: 2, 37 - 42, 31.08.2025
https://doi.org/10.55694/jamer.1649924

Öz

Fonksiyonel endoskopik sinüs cerrahisi öncesinde paranazal sinüsler, Paranazal Sinüs Bilgisayarlı Tomografi
(PSBT) ile dikkatli değerlendirilerek anatomik yapılar ve anatomik varvasyonlar dikkatle değerlendirilmektedir.
Paranazal bölgedeki anatomik yapıların ilişkisini inceleyen pek çok çalışma bildirilmiştir. Çalışmamızda pterygoid
process pnömotizasyonunun olfaktor sulkus ve anterior kafa tabanı derinliğine etkisinin Türk popülasyonunda
araştırılması amaçlanmıştır.
Gereç ve Yöntemler: 18 yaş üstü 460 hastanın PSBT görüntüleri incelenmiştir. PSBT’de, pterigoid proses
pnömatizasyonu ve Keros sınıflaması ile anterior kafa tabanı derinliği, sağ ve sol olarak ayrı ayrı değerlendirilmiştir.
Pterigoid proses pnömotizasyonunun anterior kafa tabanı derinliği ve Keros sınıflaması üzerine etkisi
değerlendirilmiştir. Tüm sonuçlar istatistiksel olarak değerlendirilmiştir.
Bulgular: 222 erkek (% 48,3 ), 238 kadın (% 51,7) toplamda 460 hastanın PSBT görüntüleri değerlendirilmiştir. Keros
klasifikasyonuna göre, sağ ve sol taraflar arasında benzer dağılımlar gözlemlenmiş olup, en yaygın %54,1 oranıyla
tip 2, bunu %28,3 oranla tip 1 ve en düşük sıklıkta %17,6 oranla tip 3 takip etmiştir. Çalışmamızda, %40,7 sağda,
%42,2 solda ve %39,1 bilateral pterygoid process pnömotizasyonu saptandı. Pterygoid process pnömotizasyonunun
Keros sınıflaması üzerinde istatistiksel anlamlı bir etkisi olmadığı saptanmıştır.
Sonuç: İkinci basamak hastanelerde psikiyatri kliniği için fiziki olarak kapalı hasta servislerinin yaygınlaştırılması,
yan dal uzmanı ve özellikle uzman sayısının az olduğu branşlarda hekim sayısının artırılması ile sevk edilen hasta
sayılarında azalma olacağı düşünülmektedir.

Etik Beyan

Ankara Bilkent Şehir Hastanesi, TABED-1-25-914/15.01.2025

Destekleyen Kurum

Rapor edilecek hiçbir destek kaynağı yoktur.

Kaynakça

  • 1. Karatay E, Avcı H. Evaluation of olfactory fossa anatomy by computed tomography and the place of Keros classification in functional endoscopic sinus surgery. South Clin Istanb Eurasia. 2021; 32 (1): 47-52.
  • 2. Vemuri NV, Karanam LSP, Manchikanti V, Dandamudi S, Puvvada SK, Vemuri VK. Imaging review of cerebrospinal fluid leaks. Indian J Radiol Imaging. 2017;27:441–446.
  • 3. Çufalı ŞA, Çetin MA, Kum NY, Karakurt SE. The Effects of Nasal Septal Deviation on Anterior Skull Base Parameters. Int Arch Otorhinolaryngol. 2024;28:e394–399.
  • 4. Reddy UDMA, Dev B. Pictorial essay: Anatomical variations of paranasal sinuses on multidetector computed tomographyHow does it help FESS surgeons? Indian J Radiol Imaging. 2012;22:317-324.
  • 5. Yousuf M, Jamil A, Hashmi Q, Hameed K, Sami M, Shaikh T, et al. Anatomical variation of the olfactory fossa according to keros and yenigun classifications in karachi, pakistan. Cureus. 2024;16:e73314.
  • 6. Erdogan S, Keskin G, Topdag M, Ozturk M, Sari F, Mutlu F. Ethmoid roof radiology; analysis of lateral lamella of cribriform plate. Otolaryngol Pol. 2015;69:31–36. https://doi. org/10.5604/00306657.1184543.
  • 7. Ulualp SO. Complications of endoscopic sinus surgery: appropriate management of complications. Curr Opin Otolaryngol Head Neck Surg. 2008;16:252–259.
  • 8. Degaga TK, Zenebe AM, Wirtu AT, Woldehawariat TD, Dellie ST, Gemechu JM. Anatomographic variants of sphenoid sinus in ethiopian population. Diagnostics (Basel). 2020;10 (11):970
  • 9. Aijaz A, Ahmed H, Fahmi S, Samreen T, Rasheed B, Jabeen H, et al. A comprehensive computed tomographic analysis of pneumatization pattern of sphenoid sinus and their association with protrusion/dehiscence of vital neurovascular structure in a pakistani subgroup. Turk Neurosurg. 2023;33(3):501-508.
  • 10. Ominde BS, Ikubor J, Igbigbi PS. Pneumatization patterns of the sphenoid sinus in adult nigerians and their clinical implications. Ethiop J Health Sci. 2021;31:1295.
  • 11. Kusch AM, Ruiz García V. Giant pneumatization of sphenoid sinus: Report of four cases and review of literature. Revista Médica Herediana. 2019;30:45.
  • 12. Sagar S, Jahan S, Kashyap SK. Prevalence of anatomical variations of sphenoid sinus and its adjacent structures pneumatization and its significance: A CT scan study. Indian J Otolaryngol Head Neck Surg. 2023;75:2979–2989.
  • 13. Keros P. On the practical value of differences in the level of the lamina cribrosa of the ethmoid. Z Laryngol Rhinol Otol. 1962;41:809-813.
  • 14. Krmpotić-Nemanić J, Vinter I, Judaš M. Transformation of the shape of the ethmoid bone during the course of life. Eur Arch Otorhinolaryngol. 1997;254:347–349.
  • 15. Birkin T, Acar T, Esen Ö. Sinonazal bölge anatomik varyasyonları ve sinüs hastalıkları ile olan ilişkisi. The Journal of Tepecik Education and Research Hospital. 2017;27:236–242.
  • 16. Güngör G. Evaluation of the variations of paranasal sinuses by computed tomography. Haydarpasa Numune Med J. 2019; 59(4): 320-327.
  • 17. Fatihoglu E, Aydin S, Karavas E, Kantarci M. The pneumatization of the sphenoid sinus, its variations and relations with surrounding neurovascular anatomic structures: A computerized tomography study. Am J Otolaryngol. 2021;42 (4):102958.
  • 18. Rahmati A, Ghafari R, Anjomshoa M. Normal variations of sphenoid sinus and the adjacent structures detected in cone beam computed tomography. J Dent Shiraz Univ Med Sci. 2016; 17(1): 32-37.
  • 19. Aijaz A, Ahmed H, Fahmi S, Samreen T, Rasheed B, Jabeen H. A Comprehensive computed tomographic analysis of pneumatization pattern of sphenoid sinus and their association with protrusion/dehiscence of vital neurovascular structure in a pakistani subgroup. Turk Neurosurg. 2023;33:501–508.
  • 20. Turkdogan FT, Turkdogan KA, Dogan M, Atalar MH. Assessment of sphenoid sinus related anatomic variations with computed tomography. Pan Afr Med J 2017;27:109.
  • 21. Kazkayasi M. Anatomic variations of the sphenoid sinus on computed tomography. Rhinology Journal 2025;43:109–114.
  • 22. Lakshman N, Viveka S, Thondupadath Assanar FB. Anatomical relationship of pterygoid process pneumatization and vidian canal. Braz J Otorhinolaryngol. 2022;88:303–308.
Toplam 22 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Kulak Burun Boğaz
Bölüm Araştırma Makalesi
Yazarlar

Öznur Gündüz 0000-0002-4509-2231

Ömer Faruk Çufalı 0000-0001-6958-0822

Yayımlanma Tarihi 31 Ağustos 2025
Gönderilme Tarihi 3 Mart 2025
Kabul Tarihi 14 Ağustos 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 10 Sayı: 2

Kaynak Göster

Vancouver Gündüz Ö, Çufalı ÖF. Prevalence of Pterygoid Process Pneumatization, Distribution of Anterior Skull Base Depth, and Their Correlation. JAMER. 2025;10(2):37-42.