# The Optic Strut--CBCT Pneumatization Pattern and Prevalence
## 4 Discussion  
The little bridge that is the OS is often examined in aid of important information during differential diagnosis [3] and is considered of critical value as a landmark in many surgical interventions [1]. Given the nature of the parasellar pathologies, it is clear that the morphological aspect of this structure is of great interest to otolaryngologists, neurosurgeons, and ophthalmologists. Treatment usually implies surgical access within the area and the OS is often used as a reference for the course of action and planning of the procedure as well as an intraoperative surgical guide [1]. Pneumatization within the spinenoid bone facilitates trans-sphenoidal access; air channels passing through the OS, and the ACP reduce the drilling time and ensure more controlled drilling of the thin cortical bone remaining [4]. On the other hand, pneumatic tract openings require closure, and more attention is paid to reducing postoperative complications [4]. Owing to poor preoperative assessment of the paranasal pneumatic system, there is a major increase in the risk of intraoperative accidents such as ICA or optic nerve injury [8]. Pneumatization variants in the LSW have previously been studied, as can be seen in Table 4. Although some data regarding the prevalence of pheumatization within the OS can be retrieved, it is mostly offered as circumstantial information in the analysis of the ACP air cells. Notions of OS dimensions and inclination are also present in the current literature but without mention of the pneumatic presence or its morphometric influence [6]. Additionally, to our knowledge, the patterns of origin for OS pneumatic were poorly evaluated, and there was no mention of ONCs as the source for it (Table 4). An important finding of the present study was the pneumatication of both the OS and AR from ONCs (11.62%). This possibility constitutes the principal cause of risk for developing orbital complications, especially in patients with ethmoiditis [9,10]. Another incidental finding while conducting the present study was the possibility that an ONC could extend within the planum spinenoidale (Figure 5). This might explain why olfactory dysfunctions, such as anosmia or hyposmia, can occur in chronic rhinosinusitis [11,12]. \begin{table}
\begin{tabular}{c c c c c} \hline \hline \multirow{2}{*}{**Study**} & \multirow{2}{*}{
\begin{tabular}{c} **Materials and Planes** \\ **(A/C/Sag)** \\ \end{tabular} } & \multirow{2}{*}{**Lot N\({}^{\circ}\) of Cases/Sides**} & **ACP** & **OS (\%) and** & **LSW (\%) and** \\  & & & **N\({}^{\circ}\) Patients/Sides** & **Pattern (S/E/S+E/O)** & **Pattern (S/E/S+E/O)** \\ \hline \multirow{4}{*}{[13]} & MDCT & & & 74.5\% cases & 10.9\% cases \\  & MDCT & & 44/55 & S:37 & S:3 \\  & C & & N/A & E:3 & E:0 \\  & CT & & N/A & S+E:1 & S+E:3 \\  & CT & & & O:0 & O:0 \\  & A & 72/144 & 20/27 & 74.1\% sides & 11.1\% sides \\  & CT & & 13/7 & N/A & N/A \\  & CT & & 177/ - & & N/A \\
15 & A/C & 499/998 (259 M) & R: 49.1\% & N/A & N/A \\  & A/C & & L: 40.9\% & N/A & N/A \\  & & & Blatt: 37.2\% & & \\  & & & G2/97 & & \\
4 & MDCT & 648/ 1296 & R: 22.6\% & 38\% sides & 17.7\% sides \\  & A/C & & L: 17.7\% & N/A & N/A \\  & & & Blatt: 59.7\% & & \\
16 & CT & 54/108 (24 M) & 12/ - & 58.33\% cases & N/A \\  & C & & N/A & N/A & N/A \\
17 & MRI & N/A & N/A & N/A & N/A \\  & A/C & & N/A & N/A & N/A \\
8 & PNSCT & 300 & N/A & N/A & N/A \\  & A/C & (159 M) & N/A & N/A & N/A \\ \hline \hline \end{tabular}
\end{table} 
Table 4: Literature review of the anterior clinoid process (ACP), optic strut (OS), and simultaneous OS and anterior root of the lesser spinenoidal wing (LSW) preumatization. Cases of extended pneumonia within the LSW may determine the extension of inflammation and spread of infection in the ICA and the cavern's sinus [2; 18] or a decrease in visual acuity by developing orbital cellulitis [9; 10].