ADDIS ABABA UNIVERSITY, COLLEGE OF HEALTH SCIENCES, SCHOOL OF MEDICINE, DEPARTMENT OF ANATOMY Anatomical Variations of Sphenoid Sinus: A Radiological Evaluation BY: Tizita Kinfe (BSc.) JUNE, 2019 Addis Ababa, Ethiopia Anatomical Variations of Sphenoid Sinus: A Radiological Evaluation Thesis submitted to Department of Anatomy, School of Medicine, College of Health Sciences, Addis Ababa University for the partial fulfillment of the requirements for the Degree of Masters of Science (MSc.) in Human Anatomy. By: Tizita Kinfe (BSc.) April, 2019 Addis Ababa, Ethiopia IDENTIFICATION Name of investigator: Tizita Kinfe (BSc.) Advisors: Principal Advisor: Abay Mulu (Ass. Prof. in Anatomy), Department of Anatomy, School of Medicine, College of Health Sciences, AAU Co advisors: 1. Dr Tequam Debebe (Ass. Prof. in Radiology, Consultant Neuroradiologist), Department of Radiology, School of Medicine, CHS, AAU. 2. Dr Seife Teferi (Aso. Prof. in Radiology, Radiation Physist), Department of Radiology, School of Medicine, CHS, AAU. Full title of project: Anatomic Variations of Sphenoid Sinus: A Radiological Evaluation Address of Investigator: AAU, College of Health Sciences, School of Medicine, Department of Anatomy Cell phone: +251-910603204 E-mail: [email protected] P.O. Box: 9086 Addis Ababa University School of Graduate Studies Declaration This is to certify that the thesis prepared by Tizita Kinfe, entitled, “Anatomic Variations of Sphenoid Sinus: A Radiological Evaluation” and submitted in partial fulfillment of the requirements for degree of Masters of Science in Anatomy complies with the regulation of the University and meets the accepted standards with respect to originality and quality. This thesis has not been presented for degree any other University, and that all sources of materials used for the thesis have been fully acknowledged. Candidate: Tizita Kinfe Signature: ------------------------ Date: ------------------ Signed by the Examining Committee: Examiner: --------------------------------------- Signature: ----------------------Date: ----------------- Advisors: Mr. Abay Mulu Signature: -------------------------- Date: ----------------- Dr Tequam Debebe Signature: -------------------------- Date: ----------------- Dr Seife Teferi Signature: -------------------------- Date: ----------------- ------------------------------------------------------------------------------ Chair of Department ACKNOWLEDGMENT I wish to express my gratitude to Mr Abay Mulu, for his guidance and supervision of this thesis. Also would like to acknowledge Dr. Tequam Debebe for her assistance in data interpretation and analysis, and Dr. Seife Teferi, for his valuable corrections and criticisms. I would like to extend my sincere thanks to the following institutions: Menelik II Health Science College for sponsoring my postgraduate study, Addis Ababa University, School of Medicine, Collage of Health Science, Department of Anatomy for shaping me to become an anatomist, Radiology Department of Tikur Anbesa Hospital for their help in sourcing all the relevant data and materials for the study. Finally, my specials thank goes to Mr. Biruk Endalkachew, and other colleagues who have direct or indirect contribution to this study, and my family for their support and encouragement throughout this study. i LIST OF ABBREVIATIONS AND ACRONYMS ACP……………………………………………………. Anterior clinoid process CP………………………………………………………..Conchal pneumatization CT………………………………………………………. Computed Tomography ENT………………………………………………………Ear-Nose-Throat ESS………………………………………………………Endoscopic Sinus Surgery FESS……………………………………………………...Functional Endoscopic Sinus Surgery GWS……………………………………………………...Greater wing of sphenoid bone HNS………………………………………………………Head and Neck Surgery ICA……………………………………………………... Internal Carotid Artery MN………………………………………………………. Maxillary Nerve MRI………………………………………………………Magnetic Resonance Imaging ON………………………………………………………. Optic Nerve ORL………………………………………………………Otorhinolaryngology PNS………………………………………………………. Paranasal sinus POP……………………………………………………… postsellar pneumatization PRP………………………………………………………. Presellar pneumatization SP………………………………………………………… Sellar pneumatization SS………………………………………………………… Sphenoid Sinus TASH……………………………………………………...Tikur Anbesa Specialized Hospital VC…………………………………………………………Vidian Canal VN……………………………………………………….. .Vidian Nerve ii Table of Contents ACKNOWLEDGMENT.................................................................................................................. i LIST OF ABBREVIATIONS AND ACRONYMS........................................................................ ii LIST OF FIGURES ....................................................................................................................... iv LIST OF TABLES .......................................................................................................................... v ABSTRACT ................................................................................................................................... vi 1. INTRODUCTION............................................................................................................. 1 1.1. Background ....................................................................................................................... 1 1.2. Morphological features of the sphenoid sinus ................................................................. 1 1.2.1. Developmental appearance ........................................................................................ 1 1.2.2. Gross appearance ........................................................................................................ 3 1.2.3 Microscopic appearance .............................................................................................. 4 1.3. Classification of sphenoid sinus ........................................................................................ 4 1.4. Diagnostic modalities (radiology).......................................................................................... 10 1.5. Statement of the problem ............................................................................................... 12 1.6. Significance of the study ................................................................................................. 13 2. LITERATURE REVIEW .............................................................................................. 14 3. OBJECTIVE OF THE STUDY ......................................................................................... 18 3.1. General Objective ............................................................................................................ 18 3.2. Specific objective .............................................................................................................. 18 4. MATERIALS AND METHODS ....................................................................................... 19 4.1. Study Design.............................................................................................................. 19 4.2. Study Population....................................................................................................... 19 4.3. Study Area ................................................................................................................. 19 4.4. Study Period .............................................................................................................. 19 4.5. Sample Size................................................................................................................ 19 4.6. Inclusion and exclusion criteria............................................................................... 20 4.7. Sampling Technique ................................................................................................. 20 4.8. Variables .................................................................................................................... 20 4.9. Data collection technique ......................................................................................... 21 iii 4.10. Data quality assurance.......................................................................................... 22 4.11. Data Analysis ......................................................................................................... 22 4.12. Ethical Considerations.......................................................................................... 22 5. RESULT............................................................................................................................... 24 6. DISCUSSION ...................................................................................................................... 30 7. STRENGTH AND LIMITATION OF THE STUDY ...................................................... 32 7.1. Strengths .......................................................................................................................... 32 7.2. Limitations ....................................................................................................................... 32 8. CONCLUSION ................................................................................................................... 33 9. RECOMMENDATION ...................................................................................................... 34 10. REFERENCES ................................................................................................................. 35 ANNEX .......................................................................................................................................