Anatomical variations of Sphenoid sinus among the population of the Eastern province of Saudi Arabia

Objective The sphenoid sinus is a key anatomical structure in skull base surgery due to its close relationship with the neighboring neurovascular structures. This study focuses on investigating the variability of the intersinus septum in the Eastern Province of Saudi Arabia through high-resolution CT imaging. By exploring these anatomical features, the research aims to enhance surgical techniques, improve patient safety, and contribute to the development of region-specific guidelines and educational resources for skull base surgeries. Design and Methods A retrospective cross-sectional study conducted on 100 patients who underwent CT scan of paranasal sinuses from January 2023 to December 2023. Various parameters from axial, sagittal, and coronal views were used to calculate the dimensions and variations of the sphenoid sinuses. Results The study revealed that the most common pneumatization type was sellar (53%), followed by postsellar (30%) and presellar (17%), with the conchal type being extremely rare (1%). The mean presellar width and depth were nearly identical at 1.47 cm and 1.46 cm, respectively. Suprasellar depth variability was slightly higher than other dimensions. The most frequent intersinus septa configurations were single (81%), with midline septa being the predominant posterior termination (52.9%). Pneumatization of the anterior clinoid process was observed in 22%, and the pterygoid process was pneumatized in 50% of cases. The rate of Onodi cells was 36%, and optic nerve protrusion was found in 26% of cases. Statistical analyses revealed significant associations between postsellar pneumatization and both pterygoid process pneumatization (p<0.001) and the presence of Onodi cells (p=0.045). Conclusion The study highlighted significant anatomical variations of the sphenoid sinus in the Eastern Province of Saudi Arabia, which have important implications for surgical planning and risk management in skull base surgeries. A detailed preoperative CT scan is essential for navigating these variations to ensure safer and more effective surgical interventions. These findings contribute valuable insights into the regional anatomical features of the sphenoid sinus and support the development of targeted surgical guidelines and educational resources.