Acta clinica Croatica, Vol. 65. No. 3, 2026.
Original scientific paper
https://doi.org/10.20471/acc.2026.65.03.09
Anatomical Variations in Transsphenoidal Surgery: Septal Deviations, Protrusions, and Dehiscence
Hamza Kasar
; Independent Researcher, Konya, Türkiye
Murat İnci
; First and Emergency Aid Program, Department of Medical Services and Techniques, Ermenek Uysal and Hasan Kalan Vocational School of Health Services, Karamanoglu Mehmetbey University, Karaman, Türkiye
Mehmet Selçuk
; Department of Anatomy, Faculty of Medicine, Nigde Ömer Halisdemir University, Niğde, Türkiye
*
Zeliha Fazlıoğulları
; Department of Anatomy, Faculty of Medicine, Selcuk University, Konya, Türkiye
Halil Özer
; Department of Radiology, Faculty of Medicine, Selcuk University, Konya, Türkiye
* Corresponding author.
Abstract
This retrospective study aimed to investigate sphenoid sinus (SS) pneumatization
types, variations in adjacent structures, and the relationship between nasal
septal deviation (NSD) and SS morphology. Computed tomography (CT) images
of the paranasal sinuses of 300 patients were examined. Sagittal and coronal SS
pneumatization types, the protrusion and dehiscence of the carotid canal (CC),
optic canal (OC), foramen rotundum (FR), and Vidian canal (VC), the presence of
NSD, and SS septa were evaluated. The most common sagittal pneumatization
was the postsellar type (60.3%). As the degree of SS pneumatization increased,
the rates of protrusion and dehiscence of the adjacent neurovascular structures
increased significantly (P < 0.05). Vidian canal protrusion and dehiscence were
the most frequently observed variations. A total of 57.2% of all SS were more
suitable for surgery due to a wide surgical window and low protrusion/dehiscence
ratio. There was no relationship between SS morphology and NSD requiring
septoplasty during surgery. As SS pneumatization increased, so did the
risk of iatrogenic damage to adjacent structures, despite the increased surgical
window. These findings once again highlighted the vital importance of detailed
CT evaluation prior to transsphenoidal surgery for patient safety.
Keywords
Computed tomography; Dehiscence; Protrusion; Sphenoid sinus; Septal deviation
Hrčak ID:
351360
URI
Publication date:
28.9.2026.
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