Sphenoid sinus expansion: a radiographic sign of intracranial hypotension and the sunken eyes, sagging brain syndrome (an American Ophthalmological Society thesis).

Timothy J McCulley
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Abstract

Purpose: To test the hypothesis that in patient with sunken eyes, sagging brain syndrome, bone remodeling is not limited to the orbits. Volumetric analysis of the sphenoid sinus is performed in this study.

Methods: In this university-based retrospective case-control study, the dimensions of the sphenoid sinus were measured in four patients (2 males, 2 females; mean age 26.3 years, range 16-38 years) out of five individuals identified with sunken eyes, sagging brain syndrome. Three measurements were taken: the distance between the orbital apices, the posterior extension of the sphenoid sinus posterior to the orbital apices, and the maximal horizontal width. The mean of each was determined and compared to that of the control group (5 males, 5 females; mean age 35.6 years, range 23-45 years).

Results: Posterior extension and width of the sphenoid sinus were markedly larger in the enophthalmic patients than in the control group: posterior extension (26.3 ± 4.1 mm vs 13.4 ± 6.3 mm, P=.0015, Student's t test), width (39.2 ± 8.7 mm vs 25.1 ± 6.9 mm, P=.0035, Student's t test). Mean distance between the orbital apices was slightly greater (36.3 ± 1.7 mm vs 34.1 ± 2.1 mm, P=.047, Student's t test).

Conclusions: Skull remodeling occurring in association with intracranial hypotension after ventriculoperitoneal shunting is not limited to the orbits. In this study we have demonstrated expansion of the sphenoid sinus. This finding adds to our knowledge and understanding of the scope of the sunken eyes, sagging brain syndrome and elucidates a clinically useful radiographic sign.

蝶窦扩张:颅内低血压和眼凹陷、脑下垂综合征的影像学征象(美国眼科学会论文)。
目的:验证眼凹陷脑下垂综合征患者骨重塑不局限于眼眶的假说。本研究对蝶窦进行了体积分析。方法:在这项以大学为基础的回顾性病例对照研究中,测量了4例患者的蝶窦尺寸(2男2女;平均年龄26.3岁,年龄范围16-38岁),其中5例确诊为眼窝、脑下垂综合征。测量眶尖之间的距离、蝶窦在眶尖后方的后伸、最大水平宽度。测定各组的平均值,并与对照组(男5例,女5例;平均年龄35.6岁,年龄范围23-45岁)。结果:眼内陷组蝶窦后伸和宽度明显大于对照组(26.3±4.1 mm vs 13.4±6.3 mm), P=。0015,学生t检验),宽度(39.2±8.7 mm vs 25.1±6.9 mm, P=。0035,学生t检验)。眶尖之间的平均距离略大(36.3±1.7 mm vs 34.1±2.1 mm, P=。047,学生t检验)。结论:脑室-腹膜分流术后伴颅内低血压的颅骨重塑并不局限于眼眶。在这项研究中,我们证实了蝶窦的扩张。这一发现增加了我们对眼凹陷、脑下垂综合征范围的认识和理解,并阐明了一个临床有用的影像学征象。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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