Ct-Based Morphometric Study of Sphenoid Sinus Pneumatization Patterns and Septal Variations in Adults

Abstract

Objective: To evaluate sphenoid sinus pneumatization patterns, septal variations, and morphometric dimensions in adults using CT imaging, and to identify clinically relevant anatomical variations.

Materials and Methods: This descriptive cross-sectional study was conducted on 200 adult CT scans of the paranasal sinuses and head obtained from patients aged 18 years and above. CT images with adequate visualization of the sphenoid sinus were included, while scans with trauma, prior surgery, congenital anomalies, or destructive lesions were excluded. Multidetector CT images were analyzed in axial, coronal, and sagittal planes. Pneumatization was classified into conchal, presellar, sellar, and postsellar types. Septal number, deviation, accessory septa, insertion sites, and morphometric parameters including anteroposterior diameter, transverse width, and vertical height were recorded. Data were analyzed using SPSS version 25.0.

Results: The study population included 112 males (56%) and 88 females (44%), with a mean age of 41.6 ± 13.2 years. The most common pneumatization pattern was sellar type (59.0%), followed by postsellar (23.0%), presellar (14.0%) and conchal type (4.0%). Lateral pneumatization was most frequently seen in the pterygoid process (31.0%): and greater wing (27.0%). A single midline septum was present in only 36.0% of cases, while deviated septum was observed in 42.0%, multiple septa in 29.0%, and accessory septa in 17.0%. Septal attachment to the carotid canal prominence was noted in 24.0% and to the optic canal in 11.0% of cases. Mean sphenoid sinus dimensions were significantly larger.

Conclusion: The sphenoid sinus demonstrates marked variability in pneumatization, septal anatomy, and dimensions among adults. Sellar pneumatization is the predominant pattern, while septal deviations and clinically significant attachments to adjacent neurovascular structures are common. Preoperative CT evaluation is essential for accurate surgical planning and for minimizing complications during endoscopic and transsphenoidal procedures.