E1970. Imaging of Lesions Affecting the Sphenoid Sinus, Central Skull Base and Parasellar Region
  1. Shivaprakash Hiremath; The Ottawa Hospital
  2. Ohoud Alaslani; The Ottawa Hospital
  3. Nader Zakhari; The Ottawa Hospital
  4. Santanu Chakraborty; The Ottawa Hospital
  5. Carlos Torres; The Ottawa Hospital
A myriad of pathologies may involve the central skull base and the parasellar region. Lesions involving the sphenoid bone, the sinus and the synchondroses, as well as those affecting the parasellar region, will be displayed in a case-based format, illustrating salient features. Focus will also be placed on the different patterns of pneumatization of the sphenoid sinus, its effect on the adjacent structures, and the implications on clinical symptoms, surgical approach, and prognostic outcome.

Educational Goals / Teaching Points
a. To illustrate the types and extent of sphenoid sinus pneumatization b. To highlight the anatomical variants influencing clinical presentation and surgical decisions of patients with sphenoid sinus pneumatization c. To review common and infrequent pathologies affecting the sphenoid sinus, central skull base and parasellar region

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We will illustrate the types of sphenoid sinus pneumatization and their impact on the clinical presentation and surgical management of lesions affecting the central skull base and parasellar region. We intend to show a wide range of lesions affecting the sphenoid sinus, including infectious, inflammatory, marrow pathologies, and neoplastic processes. We will also showcase encephaloceles associated with idiopathic intracranial hypertension and highlight complications associated with transsphenoidal surgery. We will also review traumatic (Carotid laceration), neoplastic (Chordoma, Chondrosarcoma, Ecchordosis physaliphora, and Fibrous dysplasia) and vascular pathologies (Paraclinoid ICA aneurysm) that involve the central skull base and the parasellar region.

There are a variety of lesions that may involve the sphenoid sinus, central skull base, and parasellar region. As radiologists, we need to be aware of these lesions to facilitate early diagnosis and management. Awareness of the patterns of sphenoid pneumatization also bears a significant impact on the management, and outcome, and is crucial to prevent potential iatrogenic injuries.