Kraniyofasiyal Anomalileri ve/veya Sendromları Olan Hastalarda Paranazal Sinüs Agenezisi: CBCT Görüntülerinin Retrospektif Bir Çalışması
Year 2025,
Volume: 12 Issue: 2, 214 - 219, 22.08.2025
Hülya Çakır Karabaş
,
Rabia Duman Tepe
,
Sevde Göksel
,
İlknur Özcan
Abstract
Amaç: Bu çalışmanın amacı, kraniyofasiyal anomalileri ve/veya sendromları olan hastaların konik ışınlı bilgisayarlı tomografi (KIBT) görüntülerini inceleyerek paranazal sinüs agenezisinin varlığını değerlendirmektir.
Gereç ve Yöntemler: Kraniyofasiyal anomalileri ve/veya sendromları olan ve KIBT görüntüleri görüş alanında (FOV) ilgili paranazal sinüsleri içeren 198 hasta bu çalışmaya dahil edildi. KIBT görüntüleri aksiyal, sagittal ve koronal kesitlerde incelendi. Olguların sfenoid sinüs agenezisi varlığı, yaş ve cinsiyet özellikleri kaydedildi.
Bulgular: Yaş ortalaması 16.53±8.23 olan 198 hasta (79 kadın ve 119 erkek) değerlendirildi. Sendromik olmayan 115 dudak damak yarıklı hastanın 11'inde frontal sinüs agenezisi gözlenirken, sendromik olmayan 156 dudak damak yarıklı hastanın 5'inde sfenoid sinüs agenezisi saptandı. Kleidokranial displazili 5 hasta arasında 1 frontal sinüs agenezisi ve 5 sfenoid sinüs agenezisi vakası kaydedilmiştir. 198 hastadan sağ tek taraflı frontal sinüs agenezisi erkeklerde %3.28, kadınlarda %0.65 olarak bulunmuştur. Sol tek taraflı frontal sinüs agenezisi her iki cinsiyette de eşit olarak %1,97 oranında gözlendi. Sfenoid sinüs agenezisi %5,55 oranında bilateral ve %2,02 oranında unilateral olarak saptandı. Bilateral agenezinin erkeklerde daha yüksek olduğu görüldü. Maksiller ve etmoid sinüs agenezisi saptanmadı.
Sonuç: Agenezi, genellikle kraniosinostoz sendromlarına eşlik eden nadir bir paranazal sinüs anomalisidir. Cerrahlar endoskopik cerrahi sırasında veya transsfenoidal hipofizektomi öncesinde ageneziyi göz önünde bulundurmalıdır.
Ethical Statement
Çalışma için İstanbul Üniversitesi Diş Hekimliği Fakültesi Klinik Araştırmalar Etik Kurulu’ndan onay alındı ve çalışma her aşamada Helsinki İnsan Hakları Bildirgesi kurallarına uygun olarak yürütüldü.
References
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1. Joshi A, Joshi R. A Rare Case Report of Total Aplasia of Paranasal Air Sinuses with Posterior Fossa Malformation (Dandy Walker). Int Arch Integr Med. 2017;4:250–7.
-
2. Keskin G, Üstündag E, Çiftçi E. Agenesis of sphenoid sinuses. Surg Radiol Anat. 2002;24:324–6.
-
3. Lafci Fahrioglu S, Andaloro C. Anatomy, Head and Neck, Sinus Function and Development [Internet]. StatPearls. StatPearls Publishing; 2020 [cited 2021 Feb 7]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30422521
-
4. Celebi S, Taskin U, AltIn F, Ozkul MH. Bilateral aplasia of paranasal sinuses. Eur Arch Oto-Rhino-Laryngology. 2012;269:1055–7.
-
5. Henson B, Edens MA. Anatomy, Head and Neck, Nose Sinuses [Internet]. StatPearls. StatPearls Publishing; 2019 [cited 2021 Feb 15]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30020644
-
6. Çakur B, Sumbullu MA, Durna NB. Aplasia and Agenesis of the Frontal Sinus in Turkish Individuals : A Retro- spective Study Using Dental Volumetric Tomography. Int. J. Med. Sci. 2011;8:278–82.
-
7. Korkmaz H, Korkmaz M. Total Aplasia of the Paranasal Sinuses. Allergy Rhinol. 2013;4:e105–9.
-
8. Degirmenci B, Haktanır A, Acar M, Albayrak R, Yücel A. Agenesis of sphenoid sinus: Three cases. Surg Radiol Anat. 2005;27:351–3.
-
9. Anik I, Anik Y, Koc K, Ceylan S. Agenesis of sphenoid sinuses. Clin Anat. 2005;18:217–9
-
10. Haktanir A, Acar M, Yucel A, Aycicek A, Degirmenci B, Albayrak R. Combined sphenoid and frontal sinus aplasia accompanied by bilateral maxillary and ethmoid sinus hypoplasia. Br J Radiol. 2005;78:1053–6.
-
11. Aydinlioglu A, Kavakli A, Erdem S. Absence of Frontal Sinus in Turkish Individuals. Yonsei Med J. 2003;44:215–8.
-
12. Nowak R, Mehls G. Die apllasien der sinus maxillaries und frontales unter besenderer Berucksichtigung der pneumatization bei spalttragern. Anat Anz. 1977;142:441–50.
-
13. Sonbay D, Saka C, Akın İ, Gunsoy B, Gokler A. Prevalence of sphenoid sinus agenesis in adults : a CT scan study. B-ENT. 2010;6:167–9.
-
14. Jaworek-Troć J, Walocha JA, Lipski M, Popovchenko S, Shafarenko K, Gładysz T, Depukat P, Zarzecki JJ, Chrzan R, Urbanik A, Zarzecki MP. Agenesis of the sphenoid sinus and a single sphenoid sinus: a computed tomography anatomical evaluation. Folia Morphol (Warsz). 2021;80(4):947-953. doi: 10.5603/FM.a2021.0092.
-
15. Aydinlioǧlu A, Erdem S. Maxillary and sphenoid sinus aplasia in Turkish individuals: A retrospective review using computed tomography. Clin Anat. 2004;17:618–22.
-
16. Çakur B, Sümbüllü MA, Yimaz AB. A retrospective analysis of sphenoid sinus hypoplasia and agenesis using dental volumetric CT in turkish individuals. Diagnostic Interv Radiol. 2011;17:205–8.
-
17. Antoniades K, Vahtsevanos K, Psimopoulou M, Karakasis D. Agenesis of sphenoid sinus. Orl. 1996;58:347–9.
-
18. Duman SB, Dedeoglu N, Arikan B, Altun O. Sphenoid sinus agenesis and sella turcica hypoplasia: very rare cases of two brothers with Hamamy syndrome. Surg Radiol Anat [Internet]. Springer Paris; 2020;42:1377–80. Available from: https://doi.org/10.1007/s00276-020-02558-9
-
19. Köse TE, Işler C, Sęnel SN, Sitilci T, Özcan I, Aksakall N. Frank-ter haar syndrome-additional findings? Dentomaxillofacial Radiol. 2015;45:4–7.
-
20. Butaric LN, Jones GC, Garvin HM. Revisiting global patterns of frontal sinus aplasia utilizing computed tomography. Forensic Sci Int. 2020;315:110458. doi:10.1016/j.forsciint.2020.110458.
Paranasal Sinus Agenesis in Patients with Craniofacial Anomalies and/or Syndromes: A Retrospective Study of CBCT Images
Year 2025,
Volume: 12 Issue: 2, 214 - 219, 22.08.2025
Hülya Çakır Karabaş
,
Rabia Duman Tepe
,
Sevde Göksel
,
İlknur Özcan
Abstract
Purpose: The aim of this study is to evaluate the presence of paranasal sinus agenesis by evaluating cone-beam computed tomography (CBCT) images of patients with craniofacial anomalies and/or syndromes.
Methods: 198 patients with craniofacial anomalies and/or syndromes, whose CBCT images including relevant paranasal sinuses in the field of view (FOV), were included in this study. The CBCT images were examined in axial, sagittal, and coronal sections. The presence of the sphenoid sinus agenesis, age, and gender characteristics of the cases were recorded.
Results: 198 patients (79 females and 119 males) with a mean age of 16.53±8.23 were evaluated. 11 cases of frontal sinus agenesis were observed out of 115 non-syndromic patients with cleft lip and palate, whereas 5 sphenoid sinus agenesis were detected out of 156 non-syndromic patients with cleft lip and palate. Among 5 patients with cleidocranial dysplasia, 1 case of frontal sinus agenesis and 5 cases of sphenoid sinus agenesis were noted. Out of 198 patients, right unilateral frontal sinus agenesis was found as 3.28% in men and 0.65% in women. Left unilateral frontal sinus agenesis was observed equally in both genders with a rate of 1.97%. Sphenoid sinus agenesis was detected as bilateral at 5.55% and unilateral at 2.02%. Bilateral agenesis was found to be higher in men. No maxillary and ethmoid sinus agenesis was detected.
Conclusion: Agenesis is a rare paranasal sinus abnormality usually accompanying to syndromes of craniosynostosis. Surgeons should consider agenesis during endoscopic surgery or prior to transsphenoidal hypophysectomy.
Ethical Statement
Approval for this study was obtained from the Istanbul University, Faculty of Dentistry, Clinical Research Ethics Committee, and the study was conducted in accordance with the guidelines of the Helsinki Declaration of Human Rights at every stage.
References
-
1. Joshi A, Joshi R. A Rare Case Report of Total Aplasia of Paranasal Air Sinuses with Posterior Fossa Malformation (Dandy Walker). Int Arch Integr Med. 2017;4:250–7.
-
2. Keskin G, Üstündag E, Çiftçi E. Agenesis of sphenoid sinuses. Surg Radiol Anat. 2002;24:324–6.
-
3. Lafci Fahrioglu S, Andaloro C. Anatomy, Head and Neck, Sinus Function and Development [Internet]. StatPearls. StatPearls Publishing; 2020 [cited 2021 Feb 7]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30422521
-
4. Celebi S, Taskin U, AltIn F, Ozkul MH. Bilateral aplasia of paranasal sinuses. Eur Arch Oto-Rhino-Laryngology. 2012;269:1055–7.
-
5. Henson B, Edens MA. Anatomy, Head and Neck, Nose Sinuses [Internet]. StatPearls. StatPearls Publishing; 2019 [cited 2021 Feb 15]. Available from: http://www.ncbi.nlm.nih.gov/pubmed/30020644
-
6. Çakur B, Sumbullu MA, Durna NB. Aplasia and Agenesis of the Frontal Sinus in Turkish Individuals : A Retro- spective Study Using Dental Volumetric Tomography. Int. J. Med. Sci. 2011;8:278–82.
-
7. Korkmaz H, Korkmaz M. Total Aplasia of the Paranasal Sinuses. Allergy Rhinol. 2013;4:e105–9.
-
8. Degirmenci B, Haktanır A, Acar M, Albayrak R, Yücel A. Agenesis of sphenoid sinus: Three cases. Surg Radiol Anat. 2005;27:351–3.
-
9. Anik I, Anik Y, Koc K, Ceylan S. Agenesis of sphenoid sinuses. Clin Anat. 2005;18:217–9
-
10. Haktanir A, Acar M, Yucel A, Aycicek A, Degirmenci B, Albayrak R. Combined sphenoid and frontal sinus aplasia accompanied by bilateral maxillary and ethmoid sinus hypoplasia. Br J Radiol. 2005;78:1053–6.
-
11. Aydinlioglu A, Kavakli A, Erdem S. Absence of Frontal Sinus in Turkish Individuals. Yonsei Med J. 2003;44:215–8.
-
12. Nowak R, Mehls G. Die apllasien der sinus maxillaries und frontales unter besenderer Berucksichtigung der pneumatization bei spalttragern. Anat Anz. 1977;142:441–50.
-
13. Sonbay D, Saka C, Akın İ, Gunsoy B, Gokler A. Prevalence of sphenoid sinus agenesis in adults : a CT scan study. B-ENT. 2010;6:167–9.
-
14. Jaworek-Troć J, Walocha JA, Lipski M, Popovchenko S, Shafarenko K, Gładysz T, Depukat P, Zarzecki JJ, Chrzan R, Urbanik A, Zarzecki MP. Agenesis of the sphenoid sinus and a single sphenoid sinus: a computed tomography anatomical evaluation. Folia Morphol (Warsz). 2021;80(4):947-953. doi: 10.5603/FM.a2021.0092.
-
15. Aydinlioǧlu A, Erdem S. Maxillary and sphenoid sinus aplasia in Turkish individuals: A retrospective review using computed tomography. Clin Anat. 2004;17:618–22.
-
16. Çakur B, Sümbüllü MA, Yimaz AB. A retrospective analysis of sphenoid sinus hypoplasia and agenesis using dental volumetric CT in turkish individuals. Diagnostic Interv Radiol. 2011;17:205–8.
-
17. Antoniades K, Vahtsevanos K, Psimopoulou M, Karakasis D. Agenesis of sphenoid sinus. Orl. 1996;58:347–9.
-
18. Duman SB, Dedeoglu N, Arikan B, Altun O. Sphenoid sinus agenesis and sella turcica hypoplasia: very rare cases of two brothers with Hamamy syndrome. Surg Radiol Anat [Internet]. Springer Paris; 2020;42:1377–80. Available from: https://doi.org/10.1007/s00276-020-02558-9
-
19. Köse TE, Işler C, Sęnel SN, Sitilci T, Özcan I, Aksakall N. Frank-ter haar syndrome-additional findings? Dentomaxillofacial Radiol. 2015;45:4–7.
-
20. Butaric LN, Jones GC, Garvin HM. Revisiting global patterns of frontal sinus aplasia utilizing computed tomography. Forensic Sci Int. 2020;315:110458. doi:10.1016/j.forsciint.2020.110458.