Anatomical Variations of Sphenoid Sinus Pneumatization in Libyan Adults Using Computed Tomography (CT) Scan

Abstract

Background and aims. With the help of endoscopic endonasal transsphenoidal approaches, lesions at the base of the skull can easily be accessed. The air in the nasal cavity and sphenoid sinus provides a physiological pathway for these procedures. Many factors determine the safety and course of action of the process. These include the anatomy of the patient’s sphenoid sinus and skull base. Knowledge of the different anatomical variants of this sinus may help predict and prevent complications as the extent and pattern of sinus pneumatization vary from person to person. The main aim of this study is to initially determine the anatomical variations of the sphenoid sinus pneumatization in the Libyan population. Methods. This retrospective study included computed tomography scans from 141 subjects attending healthcare centers in Benghazi, Libya, from May 2021 to March 2022. Their ages ranged from 18-80 years old, with a male-to-female ratio of (1.17:1). They were assessed for their type of sphenoid sinus based on the Güldner classification. The variability in the nature of the inter-sphenoid septum was also determined. Results. The most common types of sphenoid pneumatization were the sellar (54.6%) and postsellar (31.2%). Extensions of pneumatization were seen in the greater wing of sphenoid, pterygoid process, and anterior clinoid process in 39%, 33.3%, and 18.4% of patients, respectively. The in-tersphenoid septum was most frequently shown to be single, specifically in the midline with lateral de-viation. Conclusions. The pneumatization of the SS is variable among the Libyan population. The clinical and surgical significance of the anatomical variants has been discussed, highlighting the need for a thorough preoperative evaluation of the sinus.