Abstract

Sphenoid sinus is always non pneumatised and contains only red marrow at birth. It starts showing signs of pneumatisation as early as nine months of age and attains adult volume by adolescent years of age. It is the most uncertain and least accessible paranasal sinus. Awareness of these uncertain variations helps in minimizing the iatrogenic complications in surgical practise Objective: In this study, we assessed the prevalence of variations in sphenoid pneumatization in the South Indian population and studied the extensions of sphenoid sinus pneumatization subtypes using computed tomography. Methods: This is the observational study for 6 months including 76 patients who underwent CT of the paranasal sinuses. The axial CT was performed. Continuous axial sections were obtained parallel to the orbitomeatal line. Multiplanar reformations of paranasal sinus were assessed for the type of pneumatization and type of clival, lateral recess, lesser wing and anterior recess extensions. Results: The complete sellar, incomplete sellar, presellar and conchal types comprised 63.1%, 26.3%, 7.89% and 2.6% of patients. The extensions of pneumatization subtypes in the study population were clival in 74% subjects, lateral recess in 48%, lesser wing in 18% and anterior recess in 14% sinuses. The pure forms was seen in 30% and combined forms in 60% of sinuses. The sphenoid sinuses were extensively pneumatised, pure forms were relatively infrequent and combined forms being more frequent. Conclusion: Understanding the wide range of variability in sphenoid sinus pneumatization helps surgeons choose the best patients, provide intraoperative guidance, and anticipate intracranial lesion complications during transsphenoidal surgical procedures. Our study of sphenoid sinus has benefits for sellar and central skull base lesions as far as for both clinical and surgical implication.

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