<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2524-177X</journal-id>
<journal-title><![CDATA[Revista médica del Hospital General de México]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. med. Hosp. Gen. Méx.]]></abbrev-journal-title>
<issn>2524-177X</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Médica del Hospital General de México A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2524-177X2024000300002</article-id>
<article-id pub-id-type="doi">10.24875/hgmx.23000047</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Tomographic classification proposal for safe endoscopic surgery of the sphenoid sinus]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Moisés-Hernández]]></surname>
<given-names><![CDATA[Jorge F.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Reyes-Millán]]></surname>
<given-names><![CDATA[Montserrat]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Monroy-Hernández]]></surname>
<given-names><![CDATA[Dalia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Santamaría-Saad]]></surname>
<given-names><![CDATA[Carlos]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hernández-Serrano]]></surname>
<given-names><![CDATA[Edith]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General de México Dr. Eduardo Liceaga Service of Otorhinolaryngology and Head and Neck Surgery ]]></institution>
<addr-line><![CDATA[México City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Nacional Homeopático Otorhinolaryngology Service ]]></institution>
<addr-line><![CDATA[México City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Hospital General Regional de Orizaba No. 1 Otorhinolaryngology Service]]></institution>
<addr-line><![CDATA[Orizaba ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>09</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>09</month>
<year>2024</year>
</pub-date>
<volume>87</volume>
<numero>3</numero>
<fpage>114</fpage>
<lpage>120</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2524-177X2024000300002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2524-177X2024000300002&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2524-177X2024000300002&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Sphenoidal sinus surgery and transsphenoidal approaches are commonly used by ENT surgeons and neurosurgeons to treat various pathologies. Radiological evaluation of this area is essential to identify neurovascular structures and their anatomical relationships.  Objective: To propose a pre-surgical classification system for the sphenoid sinus, where risk groups are established in relation to neurovascular structures, with an alphanumeric code.  Methods: Retrospective study, with simple computed tomography scans of the nose and paranasal sinuses of patients from the otolaryngology and head and neck surgery service of the General Hospital of Mexico. Classified according to the transverse diameter of the sphenoid sinus: I, &lt; 29 mm; II, 29-39.9 mm; and III, &gt; 40 mm. The lateralization of included elements is their light: L, left; R, right; and B, bilateral. Anatomical element involved: N, optic nerve; V, internal carotid artery; and O, another type of element.  Results: 200 imaging studies were analyzed. The average age of the population studied was 36.2 years. 49.5% were men (n = 99) and 50.5% (n = 101) women. Grade III presents a higher risk by compromising neurovascular structures in 90.6%. The general lateralization presented was 13.5% to the right side and 13% to the contralateral side. Isolated optic nerve protrusion occurred in 13.5% (n = 11), protruding internal carotid was found in 40% (n = 80), and in 7.5% (n = 15) both elements were found protruding towards the lumen of the sphenoid sinus.  Conclusions: The proposed classification facilitates the transmission of information to the surgical team, prior to surgery, with a simple alphanumeric code, increasing the safety of the surgical procedure.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Sphenoid sinus]]></kwd>
<kwd lng="en"><![CDATA[Internal carotid artery]]></kwd>
<kwd lng="en"><![CDATA[Ophthalmic nerve]]></kwd>
<kwd lng="en"><![CDATA[Functional endoscopic sinus surgery]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ruiz-Aburto]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Valenzuela]]></surname>
<given-names><![CDATA[CS]]></given-names>
</name>
<name>
<surname><![CDATA[Yáñez]]></surname>
<given-names><![CDATA[LA]]></given-names>
</name>
<name>
<surname><![CDATA[Lemp]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Sanhueza]]></surname>
<given-names><![CDATA[ZA]]></given-names>
</name>
<name>
<surname><![CDATA[Olivares]]></surname>
<given-names><![CDATA[SP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Radiologic anatomy of sphenoidal sinus, analysis of 120 surgically intervened patients]]></article-title>
<source><![CDATA[Rev Chil Neurocir]]></source>
<year>2015</year>
<volume>41</volume>
<page-range>54-8</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rahmati]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ghafari]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Anjomshoa]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Normal variations of sphenoid sinus and the adjacent structures detected in cone beam computed tomography]]></article-title>
<source><![CDATA[J Dent]]></source>
<year>2016</year>
<volume>17</volume>
<page-range>32-7</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Bidari]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Inoue]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Yang]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Rhoton]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Extensions of the sphenoid sinus:a new classification]]></article-title>
<source><![CDATA[Neurosurgery]]></source>
<year>2010</year>
<volume>66</volume>
<page-range>797-816</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dal Secchi]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[Dolci]]></surname>
<given-names><![CDATA[RLL]]></given-names>
</name>
<name>
<surname><![CDATA[Teixeira]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Lazarini]]></surname>
<given-names><![CDATA[PR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An analysis of anatomic variations of the sphenoid sinus and its relationship to the internal carotid artery]]></article-title>
<source><![CDATA[Int Arch Otorhinolaryngol]]></source>
<year>2018</year>
<volume>22</volume>
<page-range>161-6</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[García-Pastor]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Moreno-Jiménez]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Gómez-Llata Andrade]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Microanatomía de la región selar y paraclinoidea en especímenes mexicanos]]></article-title>
<source><![CDATA[Arch Neuroci]]></source>
<year>2005</year>
<volume>10</volume>
<page-range>212-20</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Maza]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[VanKoevering]]></surname>
<given-names><![CDATA[KK]]></given-names>
</name>
<name>
<surname><![CDATA[Yanez-Siller]]></surname>
<given-names><![CDATA[JC]]></given-names>
</name>
<name>
<surname><![CDATA[Baglam]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Otto]]></surname>
<given-names><![CDATA[BA]]></given-names>
</name>
<name>
<surname><![CDATA[Prevedello]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Surgical simulation of a catastrophic internal carotid artery injury:a laser-sintered model]]></article-title>
<source><![CDATA[Int Forum Allergy Rhinol]]></source>
<year>2019</year>
<volume>9</volume>
<page-range>53-9</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Silva Méndez-Bengassi]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Vasallo García]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Cenjor Español]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anatomía y embriología de la nariz y senos paranasales]]></article-title>
<source><![CDATA[Libr Virtual Form en ORL]]></source>
<year>2017</year>
<volume>41</volume>
<page-range>1-34</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vaezi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Cardenas]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Pinheiro-Neto]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Paluzzi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Branstetter]]></surname>
<given-names><![CDATA[BF]]></given-names>
</name>
<name>
<surname><![CDATA[Gardner]]></surname>
<given-names><![CDATA[PA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Classification of sphenoid sinus pneumatization:relevance for endoscopic skull base surgery]]></article-title>
<source><![CDATA[Laryngoscope]]></source>
<year>2015</year>
<volume>125</volume>
<page-range>577-81</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lakhani]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Sadiq]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Mukhtar]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Sphenoid sinus anatomical relations and their implications in endoscopic sinus surgery]]></article-title>
<source><![CDATA[Int J Med Res Health Sci]]></source>
<year>2017</year>
<volume>6</volume>
<page-range>162-6</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Malone]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Bruni]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Wong]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Tabor]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Boyev]]></surname>
<given-names><![CDATA[KP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pneumatization patterns of the petrous apex and lateral sphenoid recess]]></article-title>
<source><![CDATA[J Neurol Surgery]]></source>
<year>2017</year>
<volume>78</volume>
<page-range>441-6</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yazici]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Evaluation of anatomical variations on paranasal sinus computed tomography]]></article-title>
<source><![CDATA[ENT Update]]></source>
<year>2018</year>
<volume>8</volume>
<page-range>175-9</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marino]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
<name>
<surname><![CDATA[Weinstein]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
<name>
<surname><![CDATA[Riley]]></surname>
<given-names><![CDATA[CA]]></given-names>
</name>
<name>
<surname><![CDATA[Levy]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Emerson]]></surname>
<given-names><![CDATA[NA]]></given-names>
</name>
<name>
<surname><![CDATA[Mccoul]]></surname>
<given-names><![CDATA[ED]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Assessment of pneumatization of the paranasal sinuses:a comprehensive and validated metric]]></article-title>
<source><![CDATA[Int Forum Allergy Rhinol]]></source>
<year>2016</year>
<volume>6</volume>
<page-range>429-36</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ilków]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Waligóra]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kunc]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kucharzewski]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pneumatization of the sphenoid sinus, dorsum sellae and posterior clinoid processes in computed tomography]]></article-title>
<source><![CDATA[Polish J Radiol]]></source>
<year>2018</year>
<volume>83</volume>
<page-range>366-71</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Tomovic]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Esmaeili]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Chan]]></surname>
<given-names><![CDATA[NJ]]></given-names>
</name>
<name>
<surname><![CDATA[Shukla]]></surname>
<given-names><![CDATA[PA]]></given-names>
</name>
<name>
<surname><![CDATA[Choudhry]]></surname>
<given-names><![CDATA[OJ]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[JK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[High-resolution computed tomography analysis of variations of the sphenoid sinus]]></article-title>
<source><![CDATA[J Neurol Surgery]]></source>
<year>2013</year>
<volume>74</volume>
<page-range>82-90</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Awadalla]]></surname>
<given-names><![CDATA[AM]]></given-names>
</name>
<name>
<surname><![CDATA[Hussein]]></surname>
<given-names><![CDATA[Y]]></given-names>
</name>
<name>
<surname><![CDATA[ElKammash]]></surname>
<given-names><![CDATA[TH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anatomical and radiological parameters of the sphenoid sinus among Egyptians and its impact on sellar region]]></article-title>
<source><![CDATA[Egypt J Neurosurg]]></source>
<year>2015</year>
<volume>30</volume>
<page-range>1-12</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Prabu]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
<name>
<surname><![CDATA[Veerapandian]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Prgadhees]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Pradeep]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Rajendran]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Neurovascular variations of sphenoid sinus:impact on transsphenoidal surgery]]></article-title>
<source><![CDATA[Int J Sci Study]]></source>
<year>2018</year>
<volume>6</volume>
<page-range>5-9</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fasunla]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Ameye]]></surname>
<given-names><![CDATA[SA]]></given-names>
</name>
<name>
<surname><![CDATA[Adebola]]></surname>
<given-names><![CDATA[OS]]></given-names>
</name>
<name>
<surname><![CDATA[Ogbole]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Adeleye]]></surname>
<given-names><![CDATA[AO]]></given-names>
</name>
<name>
<surname><![CDATA[Adekanmi]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Anatomical variations of the sphenoid sinus and nearby neurovascular structures seen on computed tomography of black Africans]]></article-title>
<source><![CDATA[East Cent African J Surg]]></source>
<year>2012</year>
<volume>17</volume>
<page-range>57-64</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kang]]></surname>
<given-names><![CDATA[YJ]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[IH]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[SW]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Surgical and radiological differences in intersphenoid sinus septation and the prevalence of Onodi cells with the endoscopic endonasal transsphenoidal approach]]></article-title>
<source><![CDATA[Medicina (Kaunas)]]></source>
<year>2022</year>
<volume>58</volume>
<page-range>1479</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[DeLano]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Fun]]></surname>
<given-names><![CDATA[FY]]></given-names>
</name>
<name>
<surname><![CDATA[Zinreich]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Relationship of the optic nerve to the posterior paranasal sinuses:a CT anatomic study]]></article-title>
<source><![CDATA[AJNR Am J Neuroradiol]]></source>
<year>1996</year>
<volume>17</volume>
<page-range>669-75</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
