Prevalence of different types of sphenoid sinus pneumatization in the Indian population: A noncontrast computed tomography-based study

Background: Trans-sphenoidal approach for various surgical interventions of sella and suprasellar pathologies is fraught with the risk of injuring vital neurovascular structures which lie nearby. Preoperative knowledge of the pattern of sphenoid sinus pneumatisation is of paramount importance to anticipate and simultaneously undertake appropriate precautions to avert any complication. Objective: To determine the prevalence of different types of sphenoid sinus pneumatisation in our population. Materials and Methods: NCCT head images of 613 patients were analysed retrospectively to determine the type of sphenoid sinus pneumatisation. Individuals in the age range of 20 to 75 years were included in the study. Individuals with age less than 20 years (pneumatisation incomplete), previous surgery involving skull base/sphenoid sinus and trauma causing hemo-sinus/fractures around skull base or having space occupying lesions around skull base/sphenoid sinus were excluded from the study. Results: The age range of evaluated patients was 20 to 75 years with mean age of 45.67 years of which 368 (60.03%) were males and 245 (39.97%) were females. There was no significant statistical difference in the prevalence of various types of sphenoid sinus pneumatisation between male and female subjects (P-value >0.05). The commonest type of sphenoid sinus pneumatisation was post-sellar type (82.71%) followed by sellar (14.68%) and pre-sellar (2.45%) type. Conchal type was extremely rare. Conclusions: Preoperative computed tomographic (CT) evaluation of sellar region is a requisite whenever trans-sphenoidal surgery is contemplated to determine the location and extent of sphenoid sinus walls to shorten operative time and to minimize morbid consequences.