Cone Beam Computed Tomography Analysis of Sphenoid Sinus Pneumatization and Relationship with Neurovascular Structures



The sphenoid sinus is considered as the most variable pneumatized structure of the skull.


The aim of the present study was to determine the prevalence of the Onodi cell as well as to evaluate the relationship between the sphenoid sinus type of pneumatization and the presence of surrounding neurovascular protrusion using cone beam computed tomography (CBCT).


The CBCT images of 500 patients/996 sides [203 males (40.6%) and 297 females (59.4%)] were analyzed in this study. The type of sphenoid sinus pneumatization, prevalence of internal carotid artery (ICA) and optic nerve (ON) protrusion and dehiscence, and also the frequency of Onodi cell were assessed.


The percentages of the conchal, presellar, sellar, postsellar (a), and postsellar (b) types of pneumatization were 1%, 11.5%, 35.5%, 38.9%, and 13.1%, respectively. The more the sphenoid sinuses pneumatized, the greater the frequency of ON and ICA protrusion and dehiscence of their wall to the sinus. The prevalence of Onodi cell was 38.8%. A significant correlation was found between ON dehiscence and the presence of Onodi cells.


The present study demonstrated a significant relationship between the sinus type and frequency of neurovascular protrusions. Therefore, the sphenoid sinus extent of pneumatization might be useful in predicting the risk of iatrogenic damage to the surrounding structures.

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Correspondence to Maryam Paknahad.

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Movahhedian, N., Paknahad, M., Abbasinia, F. et al. Cone Beam Computed Tomography Analysis of Sphenoid Sinus Pneumatization and Relationship with Neurovascular Structures. J. Maxillofac. Oral Surg. (2020).

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  • Sphenoid sinus
  • Internal carotid artery
  • Optic nerve
  • Pneumatization
  • Cone beam computed tomography