Sphenoid sinus pneumatization · Vidian canal · Anterior clinoid process · Pterygoid process · Multidetector computed tomography.

  • Igor Djoric University Clinical Center of Serbia, Center for Radiology Imaging and Clinic of Neurosurgery, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Djurdjina Kablar University of Belgrade, Faculty of Medicine, Belgrade, Serbia; University Clinical Centre of Serbia, Department for Pathology, Pathohistology, and Medical Cytology, Belgrade, Serbia
  • Ivan Milic University Clinical Center of Serbia, Clinic of Neurosurgery, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Marina Milic University Clinical Center of Serbia, Clinic of Neurosurgery, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Lazar Stankovic University Clinical Center of Serbia, Clinic of Neurosurgery, Belgrade, Serbia; University of Belgrade, Faculty of Medicine, Belgrade, Serbia
  • Zoran Radojicic University of Belgrade, Faculty of Organizational Sciences, Belgrade, Serbia
  • Ana Starcevic University of Belgrade, Faculty of Medicine, Institute of Anatomy, Belgrade, Serbia
DOI: https://doi.org/10.5937/medi0-64914
Keywords: sphenoid sinus pneumatization, Vidian canal, anterior clinoid process, pterygoid process, multidetector computed tomography

Abstract


Background: Multidetector computed tomography of the sphenoid sinus is the most accurate method for visualizing sinus pneumatization and all anatomical variations.

Objective: To characterize the patterns of pneumatization of the sphenoid sinus and assess the association with variations in the bony structures of the sinus in relation to gender and age groups.

Methods: Retrospective CT analysis of 127 patients (43 men and 84 women). Pneumatization patterns, skull base extensions, and Vidian canal types were classified.

Results: Bilateral increased sphenoid sinus pneumatization shows a very strong age association (p = 0.001), with clustering in middle-aged (40–52) and elderly (≥ 66) groups. Right-sided preserved sphenoid sinus pneumatization shows a statistically significant association with gender (χ² = 3.90, p = 0.048), with a higher proportion of males than females. Bilateral pneumatization (BPP) showed a statistically significant association with age (p = 0.019); individuals with BPP were significantly younger. Sellar type predominated (67.7%), with frequent posterior and lateral extensions. The dorsal sphenoid sinus configuration is the only variant showing a statistically significant association with age (χ² = 8.17, p = 0.043). Complete sellar type shows a strong, consistent positive association with both anterior clinoid and pterygoid process pneumatization on all sides (p ≤ 0.015, often < 0.001). Type III Vidian canal occurred in ~ 40%. Vidian canal Type I is strongly associated with pterygoid process pneumatization, especially bilaterally (p < 0.001 in all cases).

Conclusions: The cohort exhibits a highly pneumatized, surgically relevant sphenoid sinus phenotype, primarily developmental rather than symptom-driven.

 

Published
2026/04/15
Issue
Online First
Section
Original Article