Variability and Gender-Related Differences of the Bony Anatomy of the Endonasal Central Skull Base in Adults

The endoscopic endonasal approaches (EEAs) are frequently used in the treatment of skull base pathologies. We present the results of the morphometric analysis of the bony anatomy of the endonasal central skull base in adults. We analyzed 103 computed tomography (CT) scan of the face. We excluded patients <18 years or radiographic evidence of trauma, neoplasm, or infection of the skull base. The images were analyzed using OsiriX MD. We recorded the patients' demographics, clival length, anterior and posterior angles (slopes), sphenoid sinus volume, and clival surface area. Also, we measured the height of the piriform aperture and the endonasal angle in the midsagittal plane. Wilcoxon's rank-sum test was used for comparison of data with a significance level of p < 0.05. The average age was 44.9 years with 47% males. The mean clival length was 44.8 mm, posterior and anterior angles were 23.6 and 41.9 degrees, respectively. The mean clival thickness and surface area were 15.6 mm, and 8.6 cm², respectively. The mean sphenoid sinus volume, endonasal angle, and piriform height were 8 cm³, 61.1 degrees, and 32.1 mm, respectively (Figs. 1 and 2). Females had shorter clivus (43 vs. 46.4 mm, p < 0.05), wider posterior angle (43.1 vs. 40.8 degrees, p <0.05), smaller surface area (8 vs. 9.2 cm², p < 0.05), and smaller sphenoid sinus volume (7.1 vs. 8.8 cm², p < 0.05). Also, females had a shorter piriform height (30.6 vs. 33.4 mm, p < 0.05). There were significant variability and gender-based differences in the endonasal bony central skull base in adults, this variability can affect the size of the corridor, as well as the freedom of movement during the endoscopic endonasal approaches.

Fig. 1

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Artikel online veröffentlicht:
12. Februar 2021