Prevalence of Pterygoid Process Pneumatization, Distribution of Anterior Skull Base Depth, and Their Correlation

Introduction: Prior to functional endoscopic sinus surgery(FESS), Paranasal Sinus Computed Tomography(PSCT) is routinely performed to assess anatomical structures and variations in detail. Numerous studies have investigated the relationships between anatomical structures in the paranasal region. This study aims to evaluate the impact of pterygoid process pneumatization(PPP) on the depth of the olfactory sulcus and the anterior skull base(ASB) in the Turkish population. Methods: PSCT images of 460 patients aged 18 years and older were retrospectively analyzed. PPP and ASB depth were evaluated separately for the right and left sides using the Keros classification. The association between PPP and ASB depth, as well as its impact on the Keros classification, was statistically assessed. Results: A total of 460 patients were included in the study, comprising 222 males(48.3%) and 238 females(51.7%), based on PSCT images. According to the Keros classification, a similar distribution was observed between the right and left sides, with Type 2 being the most prevalent(54.1%), followed by Type 1(28.3%), while Type 3(17.6%) was the least frequent. PPP was identified in 40.7% of cases on the right side, 42.2% on the left side, and 39.1% bilaterally. Statistical analysis revealed no significant association between PPP and Keros classification. Conclusion: Our study demonstrated that PPP was present in 42.2% of cases on the left side, with Keros Type 2 being the most common classification. No significant correlation was found between PPP and ASB depth, suggesting that PPP does not influence the depth of the anterior skull base.