CT- based assessment of sphenoid sinus anatomy & neurovascular relationships in population of Jammu & Kashmir (INDIA)

Objective To evaluate anatomical variations of the sphenoid sinus and its relationships with adjacent neurovascular structures using high-resolution computed tomography (HRCT) in the Indian population, focusing on features relevant to endoscopic skull base surgery. Methods A cross-sectional study was conducted at Government Medical College, Jammu (Aug 2023–July 2024). A total of 357 adult patients with sinonasal complaints underwent non-contrast HRCT scans. Parameters assessed included sphenoid sinus pneumatization (Hammer and Radberg classification), inter-sinus septa, and relationships with the optic nerve, internal carotid artery (ICA), vidian canal, and foramen rotundum. Morphometric measurements and anatomical variants were also recorded. Statistical analysis was performed using Jamovi; p < 0.05 was considered significant. Results Sellar pneumatization was most common (89.4%). Septa attached to the optic canal and ICA were found in 7.0% and 4.48%, respectively. Optic nerve dehiscence and protrusion were observed in 8.4% and 7.4% of cases; ICA protrusion and dehiscence in 10.36% and 5.88%. Significant lateral asymmetry was noted in morphometric distances ( p < 0.05). Onodi and Haller cells were present in 3.6% and 1.4%, respectively. Conclusion HRCT demonstrates high variability in sphenoid sinus anatomy in the Indian population. Preoperative imaging is essential to identify critical variants and minimize surgical risks during endonasal and skull base procedures. Integrating these findings into radiological protocols is recommended.