Lost or fragmented bony septum of the optic canal facing the sphenoid sinus: a histological study using elderly donated cadavers

Purpose To histologically describe a direct contact (the so-called dehiscence) of the optic nerve (ON) and/or internal carotid artery (ICA) to the mucosa of posterior paranasal sinuses represented by the sphenoid sinus (SS). Methods Observations of histological sections of unilateral or bilateral skull bases (parasellar area and orbital apex) from 22 elderly cadavers were made. Results A bony septum was less than 300 mu m between the SS and ICA and 200 mu m between the SS and optic nerve. Parts of the septa were sometimes absent due to fragmentation and holes of the bony lamella (2/22 facing the ICA; 4 facing the ICA in combination with an absent bony septum facing the nerve). In these dehiscence sites, the SS submucosal tissue attached to a thick sheath (50-100 mu m in thickness) enclosing the optic nerve and ophthalmic artery and/or the ICA adventitia (50-200 mu m in thickness). The ICA sometimes contained a sclerotic plaque that attached to or even protruded into the SS. With or without dehiscence, the SS mucosa was always thin (50-100 mu m in thickness) and accompanied no mononuclear cellular infiltration or tumor. Conclusions A thin bony septum of the optic nerve or ICA had been notable as a danger point during surgery, but even a 0.05-mm-thick bone lamella might be an effective barrier against cellular infiltration or bacterial invasion from the SS. Fragmentation and holes of the bony lamella in 4 cadavers might allow cellular invasion to the optic nerve. Accordingly, unknown immunological cross talks might occur to cause demyelination.

Automated summary

This study aims to describe the direct contact between the optic nerve and/or internal carotid artery with the mucosa of the sphenoid sinus. The histological sections of skull bases from elderly cadavers were observed, and it was found that there was a thin bony septum between the sphenoid sinus and the optic nerve or internal carotid artery, which could be a potential danger point during surgery.