Evaluation of the Relationship of Sphenoid Sinus Pneumatization with Adjacent Neurovascular Structures Using Computed Tomography

Objective: The aim of this study is to evaluate the relationship between the pneumatization type of the sphenoid sinus (SS) and adjacent neurovascular structures in computed tomography (CT) images. Materials and Methods: A total of 235 patients (108 women, 127 men; age range 7-85 years) who underwent paranasal sinus CT examination were evaluated retrospectively. The degrees of pneumatization of the SS in the sagittal plane were classified as Conchal, Presellar, Sellar, or Postsellar type. In the evaluation of the coronal plane, the presence and degree of lateral extension of SS pneumatization were analyzed. The evaluation included the optic nerve, internal carotid artery (ICA), vidian canal, and foramen rotundum in relation to the SS. Spearman correlation analysis was used to evaluate the relationships between SS pneumatization patterns and neurovascular structures. Results: The most common type of pneumatization was the sellar type on both sides. In the coronal plane, the most common type of pneumatization was postrotundum type on both sides. By assessing the degree of pneumatization of the SS in the coronal plane with adjacent neurovascular structures in relation to the SS; The correlation between the protrusion of ICA into the SS from the right wall and the degree of pneumatization of the SS was found to be statistically significant. Conclusion: Detailed classification, imaging, and definition of SS pneumatization with CT, especially revealing its relationship with neurovascular structures, can prevent significant surgical complications and offer guidance for surgical procedures.