The Anatomical relationship of Optic Nerve Canal to the Posterior Paranasal Sinuses On Computerized Tomography in Iraqi Patients

  • Haider Najim Al-Tameemi College of Medicine, University of Kufa, Najaf, Iraq.
  • Haider Abdul Kadum Hassan


Objective: To determine the patterns of relationship between optic nerve canal and posterior paranasal sinuses (PNS) in Iraqi patients from Middle Euphrates region using computerized tomography (CT).
Methods:A cross-sectional observational study was conducted on 100 patients  (52male,  48 female) referred to the CT unit for evaluation of PNS. Patients were examined by the same CT devise without intravenous contrast medium. Patients with sphenoid/ethmoid tumours, trauma or history of surgical intervention andthose less than 13 years oldwere excluded.The relationship between optic canal and posterior PNSwas evaluatedusing criteria of Delano's classification. Pneumatization of the anterior and posterior clinoid processes (PACP and PPCP) and any bony dehiscence in the bony wall were observed.
Results: The most frequent type of optic canal according to Delano's classification was type I (77.5). There was no statistically significant age or gender difference. There was statistically significant higher frequency of dehiscence in higher Delano's types III (4 of 7 cases, 57.1%) and IV (6 of 8, 75%). PACP and PPCP showed statistically significant association with type IV and to lesser extent in type III.  All cases of PPCP were seen only in type III and IV with statistically significant difference.
Conclusion:The relationship between optic nerve and sphenoid sinuses was slightly different in our patients from other populations. Therefore, Iraqi radiologists and Ear-Nose-Throat surgeons need to be aware of this anatomical difference to avoid serious damage to the optic nerve. During pre-operative CT assessment, it is important for radiologist to pay attention to the presence of optic canal bony dehiscence in higher Delano's types.Presence of PACP and PPCP may alert to the presence of higher Delano's types, hence a serious optic nerve canal course.
share this Article by


1. Rice DH, Schaefer SD, Anatomy of the Paranasal Sinuses. In: Rice DH, Schaefer SD. Endoscopic Paranasal Sinus Surgery. Lippincott Williams & Wilkins, 3rd ed., 2004.
2. Van Cauwenberge P, Sys L, De Belder T, Watelet JB. Anatomy and physiology of the nose and the paranasal sinuses. Immunol Allergy Clin North Am. 2004;24:1–17.
3. Sethi DS, Stanley RE, Pillay PK. Endoscopic anatomy of the sphenoid sinus and sella turcica. J Laryngol Otol. 1995;109:951–955.
4. Bolger WE. Anatomy of the Paranasal Sinuses. In: Kennedy DW, Bolger WE, Zinreich J. Diseases of the sinuses, Diagnosis and Management. B.C. Decker, 2001.
5. Stammberger HR, Kennedy DW. Anatomic Terminology Group. Paranasal sinuses: anatomic terminology and nomenclature. Ann Otol Rhinol Laryngol Suppl. 1995;167:7–16.
6. Kantarci M, Karasen RM, Alper F, Onbas O, Okur A, Karaman A. Remarkable anatomic variations in paranasal sinus region and their clinical importance. Eur J Radiol. 2004;50:296–302.
7. Stammberger H, Kopp W. Functional Endoscopic Sinus Surgery: the Messerklinger Technique. Philadelphia, B.C. Decker, 1991, p. 283.
8. Backous DD, Esquivel CR. Skull Base Medical and Surgical Issues Commonly Encountered in the Practice of Otolaryngology, Vol. 38, 2005, pp. 13–14.
9. Sellari-Franceschini S, Berrettini S, Santoro A, Nardi M, Mazzeo S, Bartalena L, et al. Orbital decompression in Graves‘ ophthalmopathy by medial and lateral wall removal. Otolaryngol Head Neck Surg. 2005;133:185–189.
10. Fokkens W, Lund V, Mullol J. European position paper on rhinosinusitis and nasal polyps group. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2008;43:317–320.
11. Cumberworth VL, Sudderick RM, Mackay IS. Major complications of functional endoscopic sinus surgery. Clin Otolaryngol Allied Sci. 1994;19:248–253.
12. Zinreich SJ. Functional anatomy and computed tomography imaging of the paranasal sinuses. Am J Med Sci. 1998;316:2–12.
13. Badia L, Lund VJ, Wei W, Ho WK. Ethnic variation in sinonasal anatomy on CT-scanning. Rhinology. 2005;43:210–214.
14. DeLano MC, Fun FY, Zinreich SJ. Relationship of the optic nerve to the posterior paranasal sinuses: a CT anatomic study. AJNR Am J Neuroradiol. 1996;17:669–675.
15. Sapçı T, Derin E, Almaç S, Cumali R, Saydam B, Karavuş M. The relationship between the sphenoid and the posterior ethmoid sinuses and the optic nerves in Turkish patients. Rhinology. 2004;42:30–34.
16. Hewaidi G, Omami G. Anatomic variation of sphenoid sinus and related structures in Libyan population: CT scan study. Libyan J Med. 2008;3: 128–133.
17. Kajoak SA, Ayad CE, Najmeldeen M and Abdalla EA. Computerized Tomography morphometric analysis of the sphenoid sinus and related structures in Sudanese Population. Glob Adv Res J Med Med Sci. 2014;3:160–167.
How to Cite
AL-TAMEEMI, Haider Najim; HASSAN, Haider Abdul Kadum. The Anatomical relationship of Optic Nerve Canal to the Posterior Paranasal Sinuses On Computerized Tomography in Iraqi Patients. Journal of Contemporary Medical Sciences, [S.l.], v. 4, n. 3, july 2018. ISSN 2413-0516. Available at: <>. Date accessed: 24 oct. 2018.