Paranasal Sinus Agenesis in Patients with Craniofacial Anomalies and/or Syndromes: A Retrospective Study of CBCT Images

Purpose: The aim of this study is to evaluate the presence of paranasal sinus agenesis by evaluating cone-beam computed tomography (CBCT) images of patients with craniofacial anomalies and/or syndromes. Methods: 198 patients with craniofacial anomalies and/or syndromes, whose CBCT images including relevant paranasal sinuses in the field of view (FOV), were included in this study. The CBCT images were examined in axial, sagittal, and coronal sections. The presence of the sphenoid sinus agenesis, age, and gender characteristics of the cases were recorded. Results: 198 patients (79 females and 119 males) with a mean age of 16.53±8.23 were evaluated. 11 cases of frontal sinus agenesis were observed out of 115 non-syndromic patients with cleft lip and palate, whereas 5 sphenoid sinus agenesis were detected out of 156 non-syndromic patients with cleft lip and palate. Among 5 patients with cleidocranial dysplasia, 1 case of frontal sinus agenesis and 5 cases of sphenoid sinus agenesis were noted. Out of 198 patients, right unilateral frontal sinus agenesis was found as 3.28% in men and 0.65% in women. Left unilateral frontal sinus agenesis was observed equally in both genders with a rate of 1.97%. Sphenoid sinus agenesis was detected as bilateral at 5.55% and unilateral at 2.02%. Bilateral agenesis was found to be higher in men. No maxillary and ethmoid sinus agenesis was detected. Conclusion: Agenesis is a rare paranasal sinus abnormality usually accompanying to syndromes of craniosynostosis. Surgeons should consider agenesis during endoscopic surgery or prior to transsphenoidal hypophysectomy.