Mohammad Pourmehdi , Mohammad Hadi Gharib , Ehsan Fattahi , Rouzbeh Shams Amiri ,
Volume 27, Issue 4 (12-2025)
Abstract
Background and Objective: The sphenoid sinus is one of the four paranasal sinuses located within the sphenoid bone and plays a crucial role in pituitary gland surgeries. This sinus is in close proximity to vital structures, including the internal carotid artery and the optic nerve. This study was conducted to radiologically evaluate sphenoid sinus anatomical characteristics using computed tomography (CT) scans of patients referring to selected imaging centers in Gorgan, Iran.
Methods: This descriptive-analytical study was conducted on 180 patients (100 females and 80 males; mean age = 35.69±13.07 years) referring for paranasal sinus CT scans or head and neck CT scans, prescribed by a specialist physician, to the Fifth Azar Educational-Therapeutic Center and Izadi Imaging Center in Gorgan, Iran, during July and August 2020. The sphenoid sinus volume and anatomical characteristics, including the type of pneumatization, presence of septa, and carotid canal protrusion and adhesion, were examined via CT imaging.
Results: Regarding the frequency distribution of sinus types based on the site of pneumatization, 151 cases (83.8%) were postsellar, 25 (13.8%) were sellar, and 4 (2.2%) were presellar. The mean volume of the left sinus and the total sinus volume were significantly higher in men than in women (P<0.05). Carotid canal adhesion to the sphenoid sinus was observed in 20 patients (11.1%). No significant statistical difference was found between genders regarding the distribution of carotid canal adhesion, presence of accessory septa, or carotid canal protrusion. Similarly, the pneumatization of the anterior clinoid process, pterygoid process, and the greater and lesser wings of the sphenoid showed no gender-based significant differences. A significant statistical correlation was observed between left carotid protrusion and the pneumatization of the greater and lesser wings of the sphenoid, as well as pterygoid and anterior clinoid processes (P<0.05). On the right side, this correlation was not present with the pneumatization of the lesser wing. Regarding carotid canal adhesion, a significant correlation was only found with the pneumatization of the left pterygoid process (P<0.05).
Conclusion: The most common form of the sphenoid sinus was the postsellar type, and the mean total and left sinus volumes were greater in men. Gender was not found to be a reliable predictor for the extensive variations and high diversity of the sphenoid sinus anatomical characteristics.
