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

  • Najmeh Movahhedian
  • Maryam PaknahadEmail author
  • Fatemeh Abbasinia
  • Leila Khojatepour
Original Article



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.


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


Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional committee (sums12232) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Copyright information

© The Association of Oral and Maxillofacial Surgeons of India 2020

Authors and Affiliations

  1. 1.Oral and Maxillofacial Radiology Department, Dental SchoolShiraz University of Medical SciencesShirazIran
  2. 2.Oral and Dental Disease Research Center, Oral and Maxillofacial Radiology Department,Dental SchoolShiraz University of Medical SciencesShirazIran
  3. 3.Student Research Committee, Dental SchoolShiraz University of Medical SciencesShirazIran
  4. 4.Oral and Maxillofacial Radiology Department, Dental SchoolShiraz University of Medical SciencesShirazIran

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