Imaging Science in Dentistry

Korean Academy of Oral and Maxillofacial Radiology (대한영상치의학회)
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Arrested pneumatization of the sphenoid sinus mimicking intraosseous lesions of the skull base

  • Jalali, Elnaz (Department of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine) ;
  • Tadinada, Aditya (Department of Oral and Maxillofacial Radiology, University of Connecticut School of Dental Medicine)
  • Received : 2014.09.08
  • Accepted : 2014.10.20
  • Published : 2015.03.31
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Abstract

Arrested pneumatization of the sphenoid sinus is a developmental variant that is not always well recognized and is often confused with other pathologies associated with the skull base. This report describes the case of a patient referred for cone-beam computed tomography (CBCT) imaging for dental implant therapy. CBCT demonstrated a well-defined incidental lesion in the left sphenoid sinus with soft tissue-like density and sclerotic borders with internal curvilinear opacifications. The differential diagnoses included intraosseous lipoma, arrested pneumatization of the sphenoid sinus, chondrosarcoma, chondroid chordoma, and ossifying fibroma. The radiographic diagnosis of arrested pneumatization was based on the location of the lesion, its well-defined nature, the presence of internal opacifications, and lack of expansion. Gray-scale CBCT imaging of the area demonstrated values similar to fatty tissue. This case highlighted the fact that benign developmental variants associated with the skull base share similar radiographic features with more serious pathological entities.

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References

  1. Spaeth J, Krugelstein U, Schlondorff G. The paranasal sinuses in CT-imaging: development from birth to age 25. Int J Pediatr Otorhinolaryngol 1997; 39: 25-40. https://doi.org/10.1016/S0165-5876(96)01458-9
  2. Shah RK, Dhingra JK, Carter BL, Rebeiz EE. Paranasal sinus development: a radiographic study. Laryngoscope 2003; 113: 205-9. https://doi.org/10.1097/00005537-200302000-00002
  3. Scuderi AJ, Harnsberger HR, Boyer RS. Pneumatization of the paranasal sinuses: normal features of importance to the accurate interpretation of CT scans and MR images. AJR Am J Roentgenol 1993; 160: 1101-4. https://doi.org/10.2214/ajr.160.5.8470585
  4. Aoki S, Dillon WP, Barkovich AJ, Norman D. Marrow conversion before pneumatization of the sphenoid sinus: assessment with MR imaging. Radiology 1989; 172: 373-5. https://doi.org/10.1148/radiology.172.2.2748818
  5. Jang YJ, KIM SC. Pneumatization of the sphenoid sinus in children evaluated by magnetic resonance imaging. Am J Rhinol 2000; 14: 181-5. https://doi.org/10.2500/105065800782102771
  6. Szolar D, Preidler K, Ranner G, Braun H, Kern R, Wolf G, et al. Magnetic resonance assessment of age-related development of the sphenoid sinus. Br J Radiol 1994; 67: 431-5. https://doi.org/10.1259/0007-1285-67-797-431
  7. Degirmenci B, Haktanir A, Acar M, Albayrak R, Yucel A. Agenesis of sphenoid sinus: three cases. Surg Radiol Anat 2005; 27: 351-3. https://doi.org/10.1007/s00276-005-0336-5
  8. Welker KM, DeLone DR, Lane JI, Gilbertson JR. Arrested pneumatization of the skull base: imaging characteristics. AJR Am J Roentgenol 2008; 190: 1691-6. https://doi.org/10.2214/AJR.07.3131
  9. Srubiski A, Csillag A, Timperley D, Kalish L, Qiu MR, Harvey RJ. Radiological features of the intraosseous lipoma of the sphenoid. Otolaryngol Head Neck Surg 2011; 144: 617-22. https://doi.org/10.1177/0194599810392878
  10. Politi M, Romeike BF, Papanagiotou P, Nabhan A, Struffert T, Feiden W, et al. Intraosseous hemangioma of the skull with dural tail sign: radiologic features with pathologic correlation. AJNR Am J Neuroradiol 2005; 26: 2049-52.
  11. Mah P, Reeves TE, McDavid WD. Deriving Hounsfield units using grey levels in cone beam computed tomography. Dentomaxillofac Radiol 2010; 39: 323-35. https://doi.org/10.1259/dmfr/19603304
  12. Reeves TE, Mah P, McDavid WD. Deriving Hounsfield units using grey levels in cone beam CT: a clinical application. Dentomaxillofac Radiol 2012; 41: 500-8. https://doi.org/10.1259/dmfr/31640433
  13. Taccone A, Oddone M, Occhi M, Dell'Acqua A, Ciccone MA. MRI "road-map" of normal age-related bone marrow. I. Cranial bone and spine. Pediatr Radiol 1995; 25: 588-95. https://doi.org/10.1007/BF02011825
  14. Kuntzler S, Jankowski R. Arrested pneumatization: witness of paranasal sinuses development? Eur Ann Otorhinolaryngol Head Neck Dis 2014; 131: 167-70. https://doi.org/10.1016/j.anorl.2013.01.008
  15. Yonetsu K, Watanabe M, Nakamura T. Age-related expansion and reduction in aeration of the sphenoid sinus: volume assessment by helical CT scanning. AJNR Am J Neuroradiol 2000; 21: 179-82.
  16. Gurevitch O, Slavin S, Feldman AG. Conversion of red bone marrow into yellow - Cause and mechanisms. Med Hypotheses 2007; 69: 531-6. https://doi.org/10.1016/j.mehy.2007.01.052
  17. Buric N, Krasic D, Visnjic M, Katic V. Intraosseous mandibular lipoma: a case report and review of the literature. J Oral Maxillofac Surg 2001; 59: 1367-71. https://doi.org/10.1053/joms.2001.27538
  18. Erdem E, Angtuaco EC, Van Hemert R, Park JS, Al-Mefty O. Comprehensive review of intracranial chordoma. Radiographics 2003; 23: 995-1009. https://doi.org/10.1148/rg.234025176
  19. Neff B, Sataloff RT, Storey L, Hawkshaw M, Spiegel JR. Chondrosarcoma of the skull base. Laryngoscope 2002; 112: 134-9. https://doi.org/10.1097/00005537-200201000-00023
  20. Daffner RH, Kirks DR, Gehweiler JA Jr, Heaston DK. Computed tomography of fibrous dysplasia. AJR Am J Roentgenol 1982; 139: 943-8. https://doi.org/10.2214/ajr.139.5.943
  21. Politi M, Romeike BF, Papanagiotou P, Nabhan A, Struffert T, Feiden W, et al. Intraosseous hemangioma of the skull with dural tail sign: radiologic features with pathologic correlation. AJNR Am J Neuroradiol 2005; 26: 2049-52.
  22. Baumann I, Zimmermann R, Dammann F, Maassen MM. Ossifying fibroma of the ethmoid involving the orbit and the skull base. Otolaryngol Head Neck Surg 2005; 133: 158-9. https://doi.org/10.1016/j.otohns.2004.09.121
  23. Greenberg HS, Deck MD, Vikram B, Chu FC, Posner JB. Metastasis to the base of the skull: clinical findings in 43 patients. Neurology 1981; 31: 530-7. https://doi.org/10.1212/WNL.31.5.530
  24. Kosling S, Neumann K, Brandt S. CT and MRI of intrinsic space-occupying lesions of the bony skull base. Radiologe 2009; 49: 598-607. https://doi.org/10.1007/s00117-008-1802-y

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