Morphometric Analysis of the Sphenoid Sinus in Sex Determination, Pneumatization Patterns, and Variant Neurovascular Relations Among Nigerian Citizens in Port Harcourt

Morphometric Analysis of the Sphenoid Sinus in Sex Determination, Pneumatization Patterns, and Variant Neurovascular Relations Among Nigerian Citizens in Port Harcourt | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Morphometric Analysis of the Sphenoid Sinus in Sex Determination, Pneumatization Patterns, and Variant Neurovascular Relations Among Nigerian Citizens in Port Harcourt Sonny Clement Okoseimeima, Joseph Ime Obot, Jessica Princewill Erakpo, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9555652/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract This study examined the morphometric characteristics of the sphenoid sinus amongst Nigerians living in Port Harcourt using computed tomography (CT) imaging, focusing on gender and age-related variations. A total of 200 retrospective CT scans of adults aged 18 - 70 years (100 males and 100 females) were reviewed. Participants were grouped into four age ranges: 18-25, 26-40, 41-55, and 56-70 years. Measurements of sinus height, width, depth, and volume were obtained using standard radiological software. Pneumatization patterns and neurovascular relations were also evaluated. deviation, while non-normally distributed data were summarized as median and interquartile range. Categorical variables were presented as frequencies and percentages. Independent t-tests were used to assess gender differences, one-way ANOVA to determine age-related variations, and chi-square tests for associations between categorical variables. Statistical significance was set at p < 0.05. The values of height, width, depth, and volume in males were 24.6 ± 3.8 mm, 23.9 ± 4.1 mm, 18.0 mm, and 10.2 ± 3.4 cm³, respectively, while in females, 22.1 ± 3.4 mm, 22.1 ± 3.7 mm, 16.0 mm, and 8.6 ± 2.1 cm³, respectively. These results showed that males exhibited significantly larger sphenoidal sinus dimensions and volumes compared to females. It also showed significant variations in sinus volume and depth across age groups, peaking in the 41-55 age group before slightly decreasing in the oldest group. The sellar pneumatization type was the most common (54%), followed by postsellar (22%), presellar (18%), and conchal (6%). Internal carotid artery protrusion was seen in 14% of subjects, while optic nerve protrusion occurred in 9%, and both protrusions were more common in males. These findings highlight that sphenoid sinus morphology varies significantly with gender and age among Nigerians. The study emphasizes the clinical importance of preoperative CT evaluation to prevent neurovascular injury and provides reference data valuable to radiologists, surgeons, and forensic anatomists. Forensic Medicine Sphenoid sinus CT scan Pneumatization Sellar Morphometry Introduction Deep within the base of the skull is an anteriorly placed, butterfly-shaped bone often nicknamed “the keystone of the cranial floor”. This compound unpaired bone of the anterior and middle skull base is called the sphenoid bone. Parts of the bone include: a body (centrally placed, containing the sella turcica, which holds the pituitary gland), two pairs of butterfly-shaped wings (lesser and greater) projecting laterally from the body, and the two pterygoid processes projecting inferolaterally [ 1 – 3 ]. This bone shields critical neurovascular structures, including the optic nerve and internal carotid artery. Deep within the substance of the body of the sphenoid bone is an irregularly-shaped, paired, and air-filled cavity that contributes to the resonance of the voice and lightening the skull [ 4 ]. This sinus, called the sphenoid sinus (SS), is one of the four paired paranasal sinuses found within the human skull. Due to its protected anatomical position, it is one of the most inaccessible paranasal sinuses [ 5 ], making it highly resistant to traumatic degradation and pathological changes. It is one of the posterior groups of sinuses, which was classified long ago as a ‘neglected sinus’ due to the anatomical location, poor understanding, and poor accessibility, till the advent of endoscopes and modern imaging techniques [ 6 ]. Apart from being inaccessible, it is considered the most variant paranasal sinus [ 7 ], and its pathologies are difficult to diagnose due to its deep location [ 8 ]. These variations include differences in size, pneumatization patterns, and relationships with critical neurovascular structures such as the optic nerve, internal carotid artery, and vidian nerve [ 6 ]. The development of the sphenoid sinus is a prolonged process beginning from the 8th week of intrauterine life as an invagination of the posterior nasal capsule towards the sphenoid bone [ 2 , 9 ]. It is reported that the sphenoid sinus is not pneumatized at birth [ 9 ], as pneumatization normally occurs and continues postnatally [ 5 , 9 , 10 ] into its mature size by the age of 12–14 years [ 5 , 10 ], with some authors reporting a continued growth until early adulthood [ 10 ]. This continuous variation and development of the sphenoid sinus may be influenced by factors such as age, gender, and race (as Asians are reported to exhibit a greater volume of SS due to larger skulls in comparison to the rest of the body [ 11 ], whereas the Israeli population showed comparatively smaller SS [ 12 ]). This indicates that there may exist comparable differences in the SS across different localities, and it is important that those regions domesticate their values, as these variations may complicate surgical procedures like microsurgical trans-sphenoidal approach and functional endoscopic sinus surgery [ 5 ]. One possible risk factor in clinical procedures is the surgeon’s inability to recognize the racial variations in the sphenoid sinus’s anatomical markers [ 6 ]. This makes the morphometric analysis of the sphenoid sinus an increasingly valuable tool in clinical settings. This aids in surgical planning, especially during endoscopic endonasal skull base surgeries, where the risk of damaging nearby vital structures is high [ 13 , 14 ]. More recently, morphometric traits of the sphenoid sinus have shown potential in sex determination, with some studies indicating sexual dimorphism based on volumetric or linear measurements [ 15 – 17 ]. Despite the wealth of international studies, there remains limited data on the morphometric analysis of the SS in West Africa, specifically in the Port Harcourt population. This study aims to bridge this gap by analyzing computed tomography (CT) scans of the SS to evaluate sex-related differences, pneumatization patterns, and neurovascular relationships in the local context. Material and Methods This was a retrospective study conducted in the Radiology Department of a Tertiary Hospital in Nigeria after obtaining institutional ethical approval. The study was conducted in full accordance with the Declaration of Helsinki 2013 (http://www.wma.net). Brain Computed Tomography images of 200 patients (100 males, 100 females) aged ≥ 18 years who had undergone paranasal sinus CT scans for nasal and paranasal diseases, skull base disease, and maxillofacial trauma were studied for morphometric features, pneumatization patterns, and neurovascular relations. CT scans with significant motion artifacts or poor image quality, scans showing evidence of fractures, destructive lesions, extensive post-surgical changes, and patients with known congenital syndromes affecting the skull base. development was excluded. The sample size was selected using a systematic random sampling method from the eligible population. Scans were retrieved from the hospital’s Picture Archiving and Communication Systems (PACS). Each of the files were anonymized to remove all patient identifiers and assigned a unique study code to each scan file to ensure confidentiality. The anonymized datasets were loaded into DICOM Viewing and Analysis Software for precise measurement, volume rendering, and other detailed evaluation. Measurements were obtained from CT scans with 0.5 – 1.0 mm slices. A standardized electronic spreadsheet was used for recording all morphometric and categorical data. The morphometric measurements made were; Length (Anteroposterior diameter): Measured in the sagittal plane from the most posterior point of the sinus. Width (Transverse diameter): Measured in the axial plane at the widest point of the sinus. Measurement taken from maximum transverse distance on coronal plane. Height (Craniocaudal diameter): Measured in the coronal plane at the highest point of the sinus. Measurement taken from maximum cranio-caudal distance on the mid-sagittal plane. Volume of each sphenoid sinus was calculated using a semi-automated segmentation tool as proposed by Gibelli et al [18] and was computed as follows; Initialization: The CT dataset was viewed in the axial plane. Segmentation: On each axial slice, the boundary of the sphenoid sinus was manually traced. The software then calculates the area for each slice. Volume calculation: ∑ (Area of the sinus on each slice × slice thickness). The results for the length, width, and height were recorded in millimeters (mm), while those of the volume were in cubic centimeters (cm 3 ) The pneumatization pattern for each slide was classified in the sagittal plane according to the Hammer and Radberg system [19] as follows; Type I (Conchal): Non-pneumatized, with thick bone posterior to the sinus. Type II (Presellar): Pneumatized stops anterior to the anterior sellar wall. Type III (Sellar): Pneumatization extends posteriorly to form the anterior sellar wall. Type IV (Postsellar): Pneumatization extends beyond the sella into the dorsum sellae and clivus. The neurovascular relations were assessed by; Internal carotid artery canal: The presence and degree of protrusion into the sinus and the bony dehiscence was recorded as either present or absent. Optic nerve canal: The presence and degree of protrusion will be noted. Bony dehiscence was recorded as present or absent. Statistical Package for Social Sciences version 22 was used for data analysis. Descriptive statistics will be used to summarize the data. Continuous variables that followed a normal distribution were expressed as mean ± standard deviation, while non-normally distributed data were summarized as median and interquartile range. Categorical variables were presented as frequencies and percentages. Independent t-tests were used to assess gender differences, one-way ANOVA was used to determine age-related variations, and a chi-square test for associations between categorical variables. Statistical significance was set at p < 0.05. Results The brain CT scans of 100 males (50%) and 100 females (50%) randomly chosen were analyzed in this study. The scans were of individuals without evidence of paranasal sinus pathology, craniofacial deformity, or trauma. Average age for male was 42.8 ± 15.4 years, and that of females was 41.2 ± 14.7 years. The overall mean age was 42.0 ± 15.1 years. The age range distribution is shown in Table I Table I: Age Range Distribution Age Group Frequency Percentage (%) 18-25 28 14 26-40 70 35 41-55 66 33 56-70 36 18 The study sample was evenly distributed among genders, ensuring balanced and reliability in gender-based comparisons. Measurement, Reproducibility, and Reliability To ensure accuracy, intra-observer reliability testing was conducted on 40 randomly selected CT scans. Measurements were repeated using identical parameters. The intraclass correlation coefficients (ICC) were calculated for all major parameters. Table II: Measurement Reproducibility and Reliability Parameters ICC 95% Confidence Level Interpretation Height 0.94 0.91-0.97 Excellent Width 0.92 0.88-0.95 Excellent Depth 0.89 0.84-0.93 Good Volume 0.96 0.93-0.98 Excellent Morphometric Parameters Table III: Sphenoid Sinus Morphometry by Sex Parameter Male (n=100) Females (n=100) Overall (n=200) Test Statistics p-value Height (mm) 24.6 ± 3.8 22.1 ± 3.4 23.4 ± 3.8 t = 4.90 < 0.001 Width (mm) 23.9 ± 4.1 22.1 ± 3.7 23.3 ± 3.9 t = 1.56 0.12 Depth (mm) 18.0 (15.0-21.5) 16.0 (13.5-19.0) 17 (14.0-20.5) U = 914 0.015 Volume (cm 3 ) 10.2 ± 2.4 8.6 ± 2.1 9.4 ± 2.4 t = 5.02 < 0.001 Males’ sphenoidal sinus height and volume were significantly larger than those of females (at p < 0.05). Depth, a non-normally distributed parameter, was also significantly greater in males; however, width did not show a statistically significant difference between sexes. These findings align with previous morphometric studies that have demonstrated larger sphenoid sinus dimensions in males. Age-Related Variations Age group analysis was conducted using ANOVA and Kruskal-Wallis tests. Results revealed gradual increases in severe dimensions with advancing age, especially for depth and volume. Table IV: Sphenoid Sinus Height (mm) Age Group Mean ± SD 18-25 22.7 ± 3.5 26-40 23.8 ± 3.7 41-55 24.0 ± 3.8 56-70 24.9 ± 3.9 ANOVA: F(3, 96) = 2.35, p = 0.079 Although not statistically significant, a progressive increase in height with age was observed. This may suggest continued pneumatization or remodelling throughout adulthood. Table V: Sphenoid Sinus Width (mm) Age Group Mean ± SD 18-25 22.3 ± 3.5 26-40 23.2 ± 3.8 41-55 23.5 ± 4.0 56-70 24.9 ± 4.0 ANOVA: F(3, 96) = 2.76, p = 0.047 A significant difference in width across age groups was noted, with post-hoc analysis showing that older adults (56-70) had wider sinuses than younger adults (18-25 years). This may indicate progressive expansion due to continued pneumatization or reduced bone density in later years. Table VI: Sphenoid Sinus (mm) Age Group Median (IQR) 18-25 16.0 (13.5-19.0) 26-40 17.0 (14.0-20.0) 41-55 18.0 (15.0-21.5) 56-70 19.0 (16.0-22.0) Kruskal-Wallis: H = 9.8, p = 0.02 There was a statistically significant increase in sinus depth with age, confirming an age-related morphologic change. Table VII: Sphenoid Sinus Volume (cm 3 ) Age Group Mean ± SD 18-25 8.7 ± 1.9 26-40 9.6 ± 2.3 41-55 9.7 ± 2.5 56-70 10.6 ± 2.6 ANOVA: F(3, 96) = 4.82, p = 0.003 Volume increased progressively with age, peaking in the oldest age group. This may be linked to prolonged pneumatization, hormonal influence, or bone resorption with age. Pneumatization Patterns The pneumatization of the sphenoid sinus was categorized as conchal, presellar, sellar and postsellar types. Table VIII: Pneumatization Types Type Frequency Percentage (%) Conchal 12 6.0 Presellar 36 18.0 Sellar 108 54.0 Post Sellar 44 22.0 The sellar type predominated, consistent with global studies indicating its anatomical and functional dominance. Table IX: Pneumatization by Sex Type Male Female Conchal 4.0 8.0 Presellar 16.0 20.0 Sellar 60.0 48.0 Post Sellar 20.0 24.0 Chi-square ( x 2 ) = 2.14, p = 0.54 There was no significant difference between sexes in pneumatization pattern distribution. Table X: Relationship Between Pneumatization and Volume Type Mean Volume ± SD Conchal 5.9 ± 1.1 Presellar 7.8 ± 1.4 Sellar 10.0 ± 2.1 Postsellar 11.6 ± 2.3 ANOVA: F(3, 96) = 34.2, p < 0.0001 There was a strong correlation between the extent of pneumatization and sinus volume, with the postsellar type showing the largest mean volume. Neurovascular Relations and Anatomical Variations Table XI: Frequency of Neurovascular Variations by Sex Variant Total Males Females Chi-square p-value Remark Internal carotid artery 28 (14) 20 8 4.12 0.042 Significant Optic nerve protrusion 18 (9.0) 12 6 2.05 0.15 Not significant Significant at p < 0.05 Internal carotid artery protrusion occurred significantly in males, while optic nerve showed no statistical sex correlation. Table XII: Septation Patterns Patterns Frequency Percentage (%) Single septum 136 68 Multiple septum 64 32 No significant sex difference was found ( X 2 = 0.08, p = 0.78) Though there was a greater percentage of single septation (68%) over multiple septation (32%), however, it was not statistically significant. Discussion This study examined the morphometric characteristics of the sphenoidal sinus among 200 Nigerian adults aged 18 – 70 years using computed tomography (CT) imaging in Port Harcourt. The parameters analyzed included sinus height, width, depth, and volume as well as pneumatization patterns and neurovascular relations. The results were compared across gender and age groups to establish variations and possible anatomical implications. The sphenoidal sinus is one of the most variable paranasal sinuses in morphology, size, and pneumatization extent [6]. The results obtained showed that males generally had higher mean sinus dimensions (height, width, and depth) and larger average volumes compared to females. This finding aligns with previous studies [20], which reported greater sinus dimensions among males due to overall craniofacial size differences and hormonal influences on bone development. Gender Differences Statistical analysis using the independent t-test revealed significant gender-based differences (p < 0.05) in most morphometric parameters. The mean sinus volume in males was significantly higher (10.2 ± 2.4 cm 3 ) compared to females (8.6 ± 2.1 cm 3 ). This result corroborates with studies by Vidya et al [21] which demonstrated sexual dimorphism in sinus volume, suggesting the potential of the sphenoidal sinus in forensic gender identification. The larger sinus volume and linear dimensions observed in males can be attributed to hormonal and structural factors such as testosterone-induced craniofacial bone expansion during puberty. Females, although having smaller sinuses, displayed relatively symmetrical pneumatization patterns compared to males, which showed more irregular expansions and extensions into adjacent structures. Age-related Variations The result demonstrated significant age-related differences in sinus volume and depth (p < 0.05). The 26 – 40-year age group exhibited the mean volume, after which a gradual decline was observed in individuals aged 55-70 years. This trend reflects the typical patterns of sinus development, where pneumatization peaks in early adulthood and stabilizes or slightly regresses with age due to bone remodelling and mucosal thickening [22]. The youngest age group (18-25) had smaller sinus volumes, which can be attributed to incomplete pneumatization, consistent with developmental anatomy literature [23]. Conversely, the slight decrease in older individuals is consistent with senile bone changes, loss of trabecular structure and possible mucosal fibrosis. Pneumatization Patterns The distribution of the sphenoid sinus pneumatization patterns (conchal, presellar, sellar and postsellar) revealed that the sellar type was the most prevalent (58%), followed by presellar (22%), postsellar (16%) and conchal (4%). These findings are consistent with those of Adeel et al [24]. who also identified the sellar type as the predominant variant in African populations. The predominance of sellar pneumatization implies a close anatomical relationship between the sinus and vital neurovascular structures, such as the internal carotid artery (ICA) and optic nerve (ON), thereby increasing the risk of surgical complications during transsphenoidal procedures. Chi-square analysis showed a statistically significant association between pneumatization pattern and gender (p = 0.042), with postsellar types being more common in males. This suggests that deeper pneumatization and sinus extension are more likely to occur in males, potentially due to increased bone cavity expansion [25]. Neurovascular Protrusions and Relations Protrusions of the internal carotid canal and optic nerve into the sphenoidal sinus were observed in 18% and 22% of cases, respectively. Bilateral protrusions were more frequent in males. The findings align with those of Hewaidi and Omami [26], who reported similar frequencies of neurovascular protrusions in their CT-based morphometric study. Although no significant gender difference was found for optic nerve protrusion (p < 0.05), internal carotid artery protrusion showed a mild male predominance. These anatomical variations are clinically relevant, especially during endoscopic sinus surgery and trans-sphenoidal hypophysectomy, where inadvertent injury to the internal carotid artery or optic nerve can result in catastrophic complications such as massive haemorrhage or blindness [27]. Correlations Between Sinus Volume and Pneumatization Patterns Pearson correlation analysis revealed a positive correlation (r = 0.62, p < 0.01) between sinus volume and the extent of pneumatization. Larger sinuses corresponded to deeper pneumatization (sellar and post sellar types), confirming the association between volumetric expansion and pneumatization grade reported by Vidya et al. [21]. This correlation underscores the developmental interplay between bone resorption and mucosal pneumatization processes in sphenoidal sinus formation. Comparison with Previous Studies The findings of this study align with previous works by Igbinedion and Ogbole [28] in Ibadan and Oyinloye et al [29] in Lagos, which demonstrated significant sexual dimorphism and a predominance of sellar pneumatization patterns in Nigerians. The mean sinus volume in this study was slightly lower than that reported in northern populations, likely due to ethnic and environmental variations influencing craniofacial morphology. Geographical differences within Nigeria may also influence paranasal sinus morphology due to genetic heterogeneity and climate-related factors affecting bone density and mucosal adaptation [30]. Port-Harcourt, being a humid coastal environment, may present different developmental influences compared to northern dry regions. Comparison with International Studies The mean sphenoidal sinus volume in the present study is comparable to values reported among Turkish [22] and Indian [25] populations, but slightly smaller than those observed in Caucasians [21]. These variations reflect racial and craniofacial differences documented across global populations. The predominance of sellar pneumatization is, however, a universal finding across multiple ethnicities. Age-related volume decline observed here agrees with studies in Korean and Egyptian populations [31], suggesting that regression of sinus air space with aging is a global morphological trend. Clinical Implications The morphometric data derived from this study have important clinical applications. Accurate knowledge of sphenoid sinus anatomy is crucial in endoscopic trans-sphenoidal surgery for pituitary tumors, management of sphenoid sinusitis, and repair of skull base defects. Variations in pneumatization and neurovascular protrusions can significantly affect surgical approaches and risk assessment. The recognition of gender and age variations can also aid radiologists in the differential diagnosis of sinus pathologies and help surgeons avoid intraoperative complications. For instance, males with deeper pneumatization and larger sinuses are at greater risk of internal carotid artery or optic nerve exposure, necessitating careful preoperative CT evaluation. Anatomical and Forensic Relevance The sexual dimorphism shown in this study suggests that sphenoidal sinus morphometry could contribute to gender determination in forensic anthropology, especially when other skeletal markers are damaged or unavailable. Similar recommendations have been made by Oladipo et al. [32] who emphasized the reliability of paranasal sinus parameters in forensic identification. Conclusion This study established significant gender and age-related differences in sphenoidal sinus morphometry among Nigerians in Port Harcourt. Males demonstrated significantly larger sinus dimensions and volumes compared to females. The sellar pneumatization pattern was the most prevalent, and deeper pneumatization types were more common in males. Age influenced sinus volume, with a peak observed in early adulthood, followed by a gradual decline in older age groups. The observed neurovascular relations further highlight the complexity of sphenoidal sinus anatomy and its clinical implications in endoscopic and neurosurgical procedures. These findings seem to indicate that sphenoidal sinus dimensions are influenced by both biological and environmental factors and underscore the necessity of individualized radiological assessment before surgical intervention. References Ominde BS, Ikubor J, Igbigbi PS. 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Adeleke AO, Ogunlade SO, Balogun BO. Morphometric variations of the sphenoid sinus among Nigerians using CT imaging. J Clin Anat 2021;34:110–8. Ahmed RA, Hassan MA, El-Shazly A. Age-related changes in sphenoid sinus volume: A radiological study. Egypt J Otolaryngol 2020;36:1–7. Oladipo GS, Okoh PD, Akande PA. Sex determination using sphenoid sinus dimensions in a Nigerian population. J Forensic Res 2017;8:1–4. Additional Declarations The authors declare no competing interests. Supplementary Files Appendices.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9555652","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":631188279,"identity":"6f62f46b-b099-472b-a23b-d9fff1b6febb","order_by":0,"name":"Sonny Clement Okoseimeima","email":"","orcid":"","institution":"University of Port Harcourt","correspondingAuthor":false,"prefix":"","firstName":"Sonny","middleName":"Clement","lastName":"Okoseimeima","suffix":""},{"id":631188280,"identity":"979c9d50-75a0-41ca-a814-73389426bbaf","order_by":1,"name":"Joseph Ime Obot","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8ElEQVRIiWNgGAWjYBACNhDB2MDAwA+kD0AFDYjSIiHZANEiQVALA0yLAdQKwlr4xA4fYPi4w6bO+EbuwcMFFffqGNibt0kw7qjF7TDptATGmWfSJMxu5CUcnnGmWIKB51iZBOOZ43i05Bgw87YdBmrJMTjM25YgwSCRYybB2HYMj5b8D2AtxjNgWuTfENKSwwDWYiABt4UHpKUGn18MQH6RnHHmjQHQLwmSbTxpxRaJbQdwapGfnfwAFGL8/O05xp8LKhL4+dkPb7zxsa0OpxYgYP8BYzGD7QURCQyH8WlBAGYkNl5bRsEoGAWjYGQBAOPgS+xEI+dSAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0009-0007-1375-3940","institution":"University of Port Harcourt","correspondingAuthor":true,"prefix":"","firstName":"Joseph","middleName":"Ime","lastName":"Obot","suffix":""},{"id":631188283,"identity":"3bab03d7-89b1-4f15-b7c2-72a7e4de2d17","order_by":2,"name":"Jessica Princewill Erakpo","email":"","orcid":"","institution":"University of Port Harcourt","correspondingAuthor":false,"prefix":"","firstName":"Jessica","middleName":"Princewill","lastName":"Erakpo","suffix":""},{"id":631188285,"identity":"9f60c875-19c2-40e8-aaf4-548c3d821535","order_by":3,"name":"Ibinabo Fubara Bob-Manuel","email":"","orcid":"","institution":"University of Port Harcourt","correspondingAuthor":false,"prefix":"","firstName":"Ibinabo","middleName":"Fubara","lastName":"Bob-Manuel","suffix":""}],"badges":[],"createdAt":"2026-04-28 14:46:00","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-9555652/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9555652/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108075364,"identity":"216cd7c8-78f2-4dc6-a0ad-d5fbd776512a","added_by":"auto","created_at":"2026-04-29 06:42:07","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":306541,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9555652/v1/ce842b56-1083-42dc-bc6a-9cfeccc3e837.pdf"},{"id":108075247,"identity":"118f2968-1c65-429a-acf2-b9557ca5e63d","added_by":"auto","created_at":"2026-04-29 06:41:45","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":15591,"visible":true,"origin":"","legend":"","description":"","filename":"Appendices.docx","url":"https://assets-eu.researchsquare.com/files/rs-9555652/v1/354dcef46619a759505968ac.docx"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eMorphometric Analysis of the Sphenoid Sinus in Sex Determination, Pneumatization Patterns, and Variant Neurovascular Relations Among Nigerian Citizens in Port Harcourt\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eDeep within the base of the skull is an anteriorly placed, butterfly-shaped bone often nicknamed \u0026ldquo;the keystone of the cranial floor\u0026rdquo;. This compound unpaired bone of the anterior and middle skull base is called the sphenoid bone. Parts of the bone include: a body (centrally placed, containing the sella turcica, which holds the pituitary gland), two pairs of butterfly-shaped wings (lesser and greater) projecting laterally from the body, and the two pterygoid processes projecting inferolaterally [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. This bone shields critical neurovascular structures, including the optic nerve and internal carotid artery. Deep within the substance of the body of the sphenoid bone is an irregularly-shaped, paired, and air-filled cavity that contributes to the resonance of the voice and lightening the skull [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. This sinus, called the sphenoid sinus (SS), is one of the four paired paranasal sinuses found within the human skull. Due to its protected anatomical position, it is one of the most inaccessible paranasal sinuses [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], making it highly resistant to traumatic degradation and pathological changes. It is one of the posterior groups of sinuses, which was classified long ago as a \u0026lsquo;neglected sinus\u0026rsquo; due to the anatomical location, poor understanding, and poor accessibility, till the advent of endoscopes and modern imaging techniques [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Apart from being inaccessible, it is considered the most variant paranasal sinus [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], and its pathologies are difficult to diagnose due to its deep location [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. These variations include differences in size, pneumatization patterns, and relationships with critical neurovascular structures such as the optic nerve, internal carotid artery, and vidian nerve [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The development of the sphenoid sinus is a prolonged process beginning from the 8th week of intrauterine life as an invagination of the posterior nasal capsule towards the sphenoid bone [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. It is reported that the sphenoid sinus is not pneumatized at birth [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e], as pneumatization normally occurs and continues postnatally [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] into its mature size by the age of 12\u0026ndash;14 years [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e], with some authors reporting a continued growth until early adulthood [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. This continuous variation and development of the sphenoid sinus may be influenced by factors such as age, gender, and race (as Asians are reported to exhibit a greater volume of SS due to larger skulls in comparison to the rest of the body [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e], whereas the Israeli population showed comparatively smaller SS [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]). This indicates that there may exist comparable differences in the SS across different localities, and it is important that those regions domesticate their values, as these variations may complicate surgical procedures like microsurgical trans-sphenoidal approach and functional endoscopic sinus surgery [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. One possible risk factor in clinical procedures is the surgeon\u0026rsquo;s inability to recognize the racial variations in the sphenoid sinus\u0026rsquo;s anatomical markers [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. This makes the morphometric analysis of the sphenoid sinus an increasingly valuable tool in clinical settings. This aids in surgical planning, especially during endoscopic endonasal skull base surgeries, where the risk of damaging nearby vital structures is high [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. More recently, morphometric traits of the sphenoid sinus have shown potential in sex determination, with some studies indicating sexual dimorphism based on volumetric or linear measurements [\u003cspan additionalcitationids=\"CR16\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eDespite the wealth of international studies, there remains limited data on the morphometric analysis of the SS in West Africa, specifically in the Port Harcourt population. This study aims to bridge this gap by analyzing computed tomography (CT) scans of the SS to evaluate sex-related differences, pneumatization patterns, and neurovascular relationships in the local context.\u003c/p\u003e"},{"header":"Material and Methods","content":"\u003cp\u003eThis was a retrospective study conducted in the Radiology Department of a Tertiary Hospital in Nigeria after obtaining institutional ethical approval. The study was conducted in full accordance with the Declaration of Helsinki 2013 (http://www.wma.net). Brain Computed Tomography images of 200 patients (100 males, 100 females) aged \u0026ge; 18 years who had undergone paranasal sinus CT scans for nasal and paranasal diseases, skull base disease, and maxillofacial trauma were studied for morphometric features, pneumatization patterns, and neurovascular relations. CT scans with significant motion artifacts or poor image quality, scans showing evidence of fractures, destructive lesions, extensive post-surgical changes, and patients with known congenital syndromes affecting the skull base. development was excluded. The sample size was selected using a systematic random sampling method from the eligible population. Scans were retrieved from the hospital\u0026rsquo;s Picture Archiving and Communication Systems (PACS). Each of the files were anonymized to remove all patient identifiers and assigned a unique study code to each scan file to ensure confidentiality. The anonymized datasets were loaded into DICOM Viewing and Analysis Software for precise measurement, volume rendering, and other detailed evaluation. Measurements were obtained from CT scans with 0.5 \u0026ndash; 1.0 mm slices. A standardized electronic spreadsheet was used for recording all morphometric and categorical data.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe morphometric measurements made were;\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eLength (Anteroposterior diameter): Measured in the sagittal plane from the most posterior point of the sinus.\u003c/li\u003e\n \u003cli\u003eWidth (Transverse diameter): Measured in the axial plane at the widest point of the sinus. Measurement taken from maximum transverse distance on coronal plane.\u003c/li\u003e\n \u003cli\u003eHeight (Craniocaudal diameter): Measured in the coronal plane at the highest point of the sinus. Measurement taken from maximum cranio-caudal distance on the mid-sagittal plane.\u003c/li\u003e\n \u003cli\u003eVolume of each sphenoid sinus was calculated using a semi-automated segmentation tool as proposed by Gibelli et al\u0026nbsp;[18]\u0026nbsp;and was computed as follows;\u003cul style=\"list-style-type: circle;\"\u003e\n \u003cli\u003eInitialization: The CT dataset was viewed in the axial plane.\u003c/li\u003e\n \u003cli\u003eSegmentation: On each axial slice, the boundary of the sphenoid sinus was manually traced. The software then calculates the area for each slice.\u003c/li\u003e\n \u003cli\u003eVolume calculation: \u0026sum; (Area of the sinus on each slice \u0026times; slice thickness).\u003c/li\u003e\n \u003c/ul\u003e\n \u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe results for the length, width, and height were recorded in millimeters (mm), while those of the volume were in cubic centimeters (cm\u003csup\u003e3\u003c/sup\u003e)\u003c/p\u003e\n\u003cp\u003eThe pneumatization pattern for each slide was classified in the sagittal plane according to the Hammer and Radberg system\u0026nbsp;[19]\u0026nbsp;as follows;\u003c/p\u003e\n\u003cul style=\"list-style-type: circle;\"\u003e\n \u003cli\u003eType I (Conchal): Non-pneumatized, with thick bone posterior to the sinus.\u003c/li\u003e\n \u003cli\u003eType II (Presellar): Pneumatized stops anterior to the anterior sellar wall.\u003c/li\u003e\n \u003cli\u003eType III (Sellar): Pneumatization extends posteriorly to form the anterior sellar wall.\u003c/li\u003e\n \u003cli\u003eType IV (Postsellar): Pneumatization extends beyond the sella into the dorsum sellae and clivus.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eThe neurovascular relations were assessed by;\u003c/p\u003e\n\u003cul style=\"list-style-type: circle;\"\u003e\n \u003cli\u003eInternal carotid artery canal: The presence and degree of protrusion into the sinus and the bony dehiscence was recorded as either present or absent.\u003c/li\u003e\n \u003cli\u003eOptic nerve canal: The presence and degree of protrusion will be noted. Bony dehiscence was recorded as present or absent.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eStatistical Package for Social Sciences version 22 was used for data analysis. Descriptive statistics will be used to summarize the data. Continuous variables that followed a normal distribution were expressed as mean \u0026plusmn; standard deviation, while non-normally distributed data were summarized as median and interquartile range. Categorical variables were presented as frequencies and percentages. Independent t-tests were used to assess gender differences, one-way ANOVA was used to determine age-related variations, and a chi-square test for associations between categorical variables. Statistical significance was set at p \u0026lt; 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe brain CT scans of 100 males (50%) and 100 females (50%) randomly chosen were analyzed in this study. The scans were of individuals without evidence of paranasal sinus pathology, craniofacial deformity, or trauma. Average age for male was 42.8\u0026nbsp;\u0026plusmn; 15.4 years, and that of females was 41.2 \u0026plusmn; 14.7 years. The overall mean age was 42.0 \u0026plusmn; 15.1 years. The age range distribution is shown in Table I\u003c/p\u003e\n\u003cp\u003eTable I: Age Range Distribution\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eAge Group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e18-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e26-40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e41-55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e56-70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe study sample was evenly distributed among genders, ensuring balanced and reliability in gender-based comparisons.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMeasurement, Reproducibility, and Reliability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo ensure accuracy, intra-observer reliability testing was conducted on 40 randomly selected CT scans. Measurements were repeated using identical parameters. The intraclass correlation coefficients (ICC) were calculated for all major parameters.\u003c/p\u003e\n\u003cp\u003eTable II: Measurement Reproducibility and Reliability\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eParameters\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eICC\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e95% Confidence Level\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eInterpretation\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eHeight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.94\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.91-0.97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eExcellent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eWidth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.88-0.95\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eExcellent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eDepth\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.84-0.93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eGood\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eVolume\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003e0.93-0.98\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 150px;\"\u003e\n \u003cp\u003eExcellent\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMorphometric Parameters\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable III: Sphenoid Sinus Morphometry by Sex\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eParameter\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eMale (n=100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eFemales (n=100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eOverall (n=200)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eTest Statistics\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eHeight (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e24.6\u0026nbsp;\u0026plusmn;\u0026nbsp;3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e22.1\u0026nbsp;\u0026plusmn;\u0026nbsp;3.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e23.4\u0026nbsp;\u0026plusmn;\u0026nbsp;3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003et = 4.90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eWidth (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e23.9\u0026nbsp;\u0026plusmn;\u0026nbsp;4.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e22.1\u0026nbsp;\u0026plusmn;\u0026nbsp;3.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e23.3\u0026nbsp;\u0026plusmn;\u0026nbsp;3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003et = 1.56\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eDepth (mm)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e18.0 (15.0-21.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e16.0 (13.5-19.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e17 (14.0-20.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eU = 914\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e0.015\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003eVolume (cm\u003csup\u003e3\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e10.2\u0026nbsp;\u0026plusmn;\u0026nbsp;2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e8.6\u0026nbsp;\u0026plusmn;\u0026nbsp;2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e9.4\u0026nbsp;\u0026plusmn;\u0026nbsp;2.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003et = 5.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 100px;\"\u003e\n \u003cp\u003e\u0026lt; 0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eMales\u0026rsquo; sphenoidal sinus height and volume were significantly larger than those of females (at p \u0026lt; 0.05). Depth, a non-normally distributed parameter, was also significantly greater in males; however, width did not show a statistically significant difference between sexes. These findings align with previous morphometric studies that have demonstrated larger sphenoid sinus dimensions in males.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAge-Related Variations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAge group analysis was conducted using ANOVA and Kruskal-Wallis tests. Results revealed gradual increases in severe dimensions with advancing age, especially for depth and volume.\u003c/p\u003e\n\u003cp\u003eTable IV: Sphenoid Sinus Height (mm)\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eAge Group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMean\u0026nbsp;\u0026plusmn;\u0026nbsp;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e18-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e22.7\u0026nbsp;\u0026plusmn; 3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e26-40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e23.8\u0026nbsp;\u0026plusmn; 3.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e41-55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e24.0\u0026nbsp;\u0026plusmn; 3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e56-70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e24.9\u0026nbsp;\u0026plusmn; 3.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eANOVA: F(3, 96) = 2.35, p = 0.079\u003c/p\u003e\n\u003cp\u003eAlthough not statistically significant, a progressive increase in height with age was observed. This may suggest continued pneumatization or remodelling throughout adulthood.\u003c/p\u003e\n\u003cp\u003eTable V: Sphenoid Sinus Width (mm)\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eAge Group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMean\u0026nbsp;\u0026plusmn;\u0026nbsp;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e18-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e22.3\u0026nbsp;\u0026plusmn; 3.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e26-40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e23.2\u0026nbsp;\u0026plusmn; 3.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e41-55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e23.5\u0026nbsp;\u0026plusmn; 4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e56-70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e24.9\u0026nbsp;\u0026plusmn; 4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eANOVA: F(3, 96) = 2.76, p = 0.047\u003c/p\u003e\n\u003cp\u003eA significant difference in width across age groups was noted, with post-hoc analysis showing that older adults (56-70) had wider sinuses than younger adults (18-25 years). This may indicate progressive expansion due to continued pneumatization or reduced bone density in later years.\u003c/p\u003e\n\u003cp\u003eTable VI: Sphenoid Sinus (mm)\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eAge Group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMedian (IQR)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e18-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e16.0 (13.5-19.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e26-40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e17.0 (14.0-20.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e41-55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e18.0 (15.0-21.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e56-70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e19.0 (16.0-22.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eKruskal-Wallis: H = 9.8, p = 0.02\u003c/p\u003e\n\u003cp\u003eThere was a statistically significant increase in sinus depth with age, confirming an age-related morphologic change.\u003c/p\u003e\n\u003cp\u003eTable VII: Sphenoid Sinus Volume (cm\u003csup\u003e3\u003c/sup\u003e)\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eAge Group\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMean\u0026nbsp;\u0026plusmn;\u0026nbsp;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e18-25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e8.7\u0026nbsp;\u0026plusmn; 1.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e26-40\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e9.6\u0026nbsp;\u0026plusmn; 2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e41-55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e9.7\u0026nbsp;\u0026plusmn; 2.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003e56-70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e10.6\u0026nbsp;\u0026plusmn; 2.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eANOVA: F(3, 96) = 4.82, p = 0.003\u003c/p\u003e\n\u003cp\u003eVolume increased progressively with age, peaking in the oldest age group. This may be linked to prolonged pneumatization, hormonal influence, or bone resorption with age.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePneumatization Patterns\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe pneumatization of the sphenoid sinus was categorized as conchal, presellar, sellar and postsellar types.\u003c/p\u003e\n\u003cp\u003eTable VIII: Pneumatization Types\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 166px;\"\u003e\n \u003cp\u003eType\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 166px;\"\u003e\n \u003cp\u003eConchal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e6.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 166px;\"\u003e\n \u003cp\u003ePresellar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e18.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 166px;\"\u003e\n \u003cp\u003eSellar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e54.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 166px;\"\u003e\n \u003cp\u003ePost Sellar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e22.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe sellar type predominated, consistent with global studies indicating its anatomical and functional dominance.\u003c/p\u003e\n\u003cp\u003eTable IX: Pneumatization by Sex\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 166px;\"\u003e\n \u003cp\u003eType\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 166px;\"\u003e\n \u003cp\u003eConchal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e4.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e8.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 166px;\"\u003e\n \u003cp\u003ePresellar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e16.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 166px;\"\u003e\n \u003cp\u003eSellar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e60.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e48.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 166px;\"\u003e\n \u003cp\u003ePost Sellar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 151px;\"\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e24.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eChi-square (\u003cem\u003ex\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e) = 2.14, p = 0.54\u003c/p\u003e\n\u003cp\u003eThere was no significant difference between sexes in pneumatization pattern distribution.\u003c/p\u003e\n\u003cp\u003eTable X: Relationship Between Pneumatization and Volume\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eType\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMean Volume\u0026nbsp;\u0026plusmn;\u0026nbsp;SD\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eConchal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e5.9\u0026nbsp;\u0026plusmn; 1.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003ePresellar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e7.8 \u0026plusmn; 1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003eSellar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e10.0\u0026nbsp;\u0026plusmn; 2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 217px;\"\u003e\n \u003cp\u003ePostsellar\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e11.6\u0026nbsp;\u0026plusmn; 2.3\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eANOVA: F(3, 96) = 34.2, p \u0026lt; 0.0001\u003c/p\u003e\n\u003cp\u003eThere was a strong correlation between the extent of pneumatization and sinus volume, with the postsellar type showing the largest mean volume.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNeurovascular Relations and Anatomical Variations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable XI: Frequency of Neurovascular Variations by Sex\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eVariant\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003eMales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eFemales\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eChi-square\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003eRemark\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eInternal carotid artery\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e28 (14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e4.12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.042\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003eSignificant\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 101px;\"\u003e\n \u003cp\u003eOptic nerve protrusion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 88px;\"\u003e\n \u003cp\u003e18 (9.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 87px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e2.05\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 75px;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 73px;\"\u003e\n \u003cp\u003eNot significant\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eSignificant at p \u0026lt; 0.05\u003c/p\u003e\n\u003cp\u003eInternal carotid artery protrusion occurred significantly in males, while optic nerve showed no statistical sex correlation.\u003c/p\u003e\n\u003cp\u003eTable XII: Septation Patterns\u003c/p\u003e\n\u003cdiv align=\"\"\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003ePatterns\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003ePercentage (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eSingle septum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 213px;\"\u003e\n \u003cp\u003eMultiple septum\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 195px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 194px;\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eNo significant sex difference was found (\u003cem\u003eX\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e = 0.08, p = 0.78)\u003c/p\u003e\n\u003cp\u003eThough there was a greater percentage of single septation (68%) over multiple septation (32%), however, it was not statistically significant.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study examined the morphometric characteristics of the sphenoidal sinus among 200 Nigerian adults aged 18 \u0026ndash; 70 years using computed tomography (CT) imaging in Port Harcourt. The parameters analyzed included sinus height, width, depth, and volume as well as pneumatization patterns and neurovascular relations. The results were compared across gender and age groups to establish variations and possible anatomical implications.\u003c/p\u003e\n\u003cp\u003eThe sphenoidal sinus is one of the most variable paranasal sinuses in morphology, size, and pneumatization extent\u0026nbsp;[6]. The results obtained showed that males generally had higher mean sinus dimensions (height, width, and depth) and larger average volumes compared to females. This finding aligns with previous studies\u0026nbsp;[20], which reported greater sinus dimensions among males due to overall craniofacial size differences and hormonal influences on bone development.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eGender Differences\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eStatistical analysis using the independent t-test revealed significant gender-based differences (p \u0026lt; 0.05) in most morphometric parameters. The mean sinus volume in males was significantly higher (10.2 \u0026plusmn; 2.4 cm\u003csup\u003e3\u003c/sup\u003e) compared to females (8.6 \u0026plusmn; 2.1 cm\u003csup\u003e3\u003c/sup\u003e). This result corroborates with studies by Vidya et al\u0026nbsp;[21]\u0026nbsp;which demonstrated sexual dimorphism in sinus volume, suggesting the potential of the sphenoidal sinus in forensic gender identification.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe larger sinus volume and linear dimensions observed in males can be attributed to hormonal and structural factors such as testosterone-induced craniofacial bone expansion during puberty. Females, although having smaller sinuses, displayed relatively symmetrical pneumatization patterns compared to males, which showed more irregular expansions and extensions into adjacent structures.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAge-related Variations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe result demonstrated significant age-related differences in sinus volume and depth (p \u0026lt; 0.05). The 26 \u0026ndash; 40-year age group exhibited the mean volume, after which a gradual decline was observed in individuals aged 55-70 years. This trend reflects the typical patterns of sinus development, where pneumatization peaks in early adulthood and stabilizes or slightly regresses with age due to bone remodelling and mucosal thickening\u0026nbsp;[22].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe youngest age group (18-25) had smaller sinus volumes, which can be attributed to incomplete pneumatization, consistent with developmental anatomy literature\u0026nbsp;[23]. Conversely, the slight decrease in older individuals is consistent with senile bone changes, loss of trabecular structure and possible mucosal fibrosis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePneumatization Patterns\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe distribution of the sphenoid sinus pneumatization patterns (conchal, presellar, sellar and postsellar) revealed that the sellar type was the most prevalent (58%), followed by presellar (22%), postsellar (16%) and conchal (4%). These findings are consistent with those of Adeel et al\u0026nbsp;[24]. who also identified the sellar type as the predominant variant in African populations. The predominance of sellar pneumatization implies a close anatomical relationship between the sinus and vital neurovascular structures, such as the internal carotid artery (ICA) and optic nerve (ON), thereby increasing the risk of surgical complications during transsphenoidal procedures.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eChi-square analysis showed a statistically significant association between pneumatization pattern and gender (p = 0.042), with postsellar types being more common in males. This suggests that deeper pneumatization and sinus extension are more likely to occur in males, potentially due to increased bone cavity expansion\u0026nbsp;[25].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eNeurovascular Protrusions and Relations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eProtrusions of the internal carotid canal and optic nerve into the sphenoidal sinus were observed in 18% and 22% of cases, respectively. Bilateral protrusions were more frequent in males. The findings align with those of Hewaidi and Omami\u0026nbsp;[26], who reported similar frequencies of neurovascular protrusions in their CT-based morphometric study. Although no significant gender difference was found for optic nerve protrusion (p \u0026lt; 0.05), internal carotid artery protrusion showed a mild male predominance.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThese anatomical variations are clinically relevant, especially during endoscopic sinus surgery and trans-sphenoidal hypophysectomy, where inadvertent injury to the internal carotid artery or optic nerve can result in catastrophic complications such as massive haemorrhage or blindness\u0026nbsp;[27].\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorrelations Between Sinus Volume and Pneumatization Patterns\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePearson correlation analysis revealed a positive correlation (r = 0.62, p \u0026lt; 0.01) between sinus volume and the extent of pneumatization. Larger sinuses corresponded to deeper pneumatization (sellar and post sellar types), confirming the association between volumetric expansion and pneumatization grade reported by Vidya et al.\u0026nbsp;[21]. This correlation underscores the developmental interplay between bone resorption and mucosal pneumatization processes in sphenoidal sinus formation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison with Previous Studies\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe findings of this study align with previous works by Igbinedion and Ogbole\u0026nbsp;[28]\u0026nbsp;in Ibadan and Oyinloye et al\u0026nbsp;[29]\u0026nbsp;in Lagos, which demonstrated significant sexual dimorphism and a predominance of sellar pneumatization patterns in Nigerians. The mean sinus volume in this study was slightly lower than that reported in northern populations, likely due to ethnic and environmental variations influencing craniofacial morphology.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGeographical differences within Nigeria may also influence paranasal sinus morphology due to genetic heterogeneity and climate-related factors affecting bone density and mucosal adaptation\u0026nbsp;[30]. Port-Harcourt, being a humid coastal environment, may present different developmental influences compared to northern dry regions.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eComparison with International Studies\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe mean sphenoidal sinus volume in the present study is comparable to values reported among Turkish\u0026nbsp;[22]\u0026nbsp;and Indian\u0026nbsp;[25]\u0026nbsp;populations, but slightly smaller than those observed in Caucasians\u0026nbsp;[21]. These variations reflect racial and craniofacial differences documented across global populations. The predominance of sellar pneumatization is, however, a universal finding across multiple ethnicities.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAge-related volume decline observed here agrees with studies in Korean and Egyptian populations\u0026nbsp;[31], suggesting that regression of sinus air space with aging is a global morphological trend.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Implications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe morphometric data derived from this study have important clinical applications. Accurate knowledge of sphenoid sinus anatomy is crucial in endoscopic trans-sphenoidal surgery for pituitary tumors, management of sphenoid sinusitis, and repair of skull base defects. Variations in pneumatization and neurovascular protrusions can significantly affect surgical approaches and risk assessment.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe recognition of gender and age variations can also aid radiologists in the differential diagnosis of sinus pathologies and help surgeons avoid intraoperative complications. For instance, males with deeper pneumatization and larger sinuses are at greater risk of internal carotid artery or optic nerve exposure, necessitating careful preoperative CT evaluation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnatomical and Forensic Relevance\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe sexual dimorphism shown in this study suggests that sphenoidal sinus morphometry could contribute to gender determination in forensic anthropology, especially when other skeletal markers are damaged or unavailable. Similar recommendations have been made by Oladipo et al. [32] who emphasized the reliability of paranasal sinus parameters in forensic identification.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study established significant gender and age-related differences in sphenoidal sinus morphometry among Nigerians in Port Harcourt. Males demonstrated significantly larger sinus dimensions and volumes compared to females. The sellar pneumatization pattern was the most prevalent, and deeper pneumatization types were more common in males.\u003c/p\u003e \u003cp\u003eAge influenced sinus volume, with a peak observed in early adulthood, followed by a gradual decline in older age groups. The observed neurovascular relations further highlight the complexity of sphenoidal sinus anatomy and its clinical implications in endoscopic and neurosurgical procedures.\u003c/p\u003e \u003cp\u003eThese findings seem to indicate that sphenoidal sinus dimensions are influenced by both biological and environmental factors and underscore the necessity of individualized radiological assessment before surgical intervention.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eOminde BS, Ikubor J, Igbigbi PS. Pneumatization Patterns of the Sphenoid Sinus in Adult Nigerians and Their Clinical Implications. Ethiop J Health Sci 2021;31:1295\u0026ndash;302. https://doi.org/10.4314/ejhs.v31i6.26.\u003c/li\u003e\n\u003cli\u003eStandring S. Gray\u0026rsquo;s Anatomy: The Anatomical Basis of Clinical Practice. 41st ed. Elsevier; 2016.\u003c/li\u003e\n\u003cli\u003eStone J. Sphenoid Bone - Location - Structure - Function - TeachMeAnatomy. TeachMe Anat 2025. https://teachmeanatomy.info/head/osteology/sphenoid-bone/ (accessed April 6, 2026).\u003c/li\u003e\n\u003cli\u003eJamil RT, Callahan AL. Anatomy, Sphenoid Bone. StatPearls, Treasure Island (FL): StatPearls Publishing; 2023.\u003c/li\u003e\n\u003cli\u003eSingh P, Hung K, Ajmera DH, Yeung AWK, von Arx T, Bornstein MM. Morphometric characteristics of the sphenoid sinus and potential influencing factors: a retrospective assessment using cone beam computed tomography (CBCT). Anat Sci Int 2021;96:544\u0026ndash;55. https://doi.org/10.1007/s12565-021-00622-x.\u003c/li\u003e\n\u003cli\u003eAnusha B, Baharudin A, Philip R, Harvinder S, Shaffie BM. Anatomical variations of the sphenoid sinus and its adjacent structures: a review of existing literature. Surg Radiol Anat 2014;36:419\u0026ndash;27. https://doi.org/10.1007/s00276-013-1214-1.\u003c/li\u003e\n\u003cli\u003eOnwuchekwa RC, Alazigha N. 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Int J Morphol 2017;35:1261\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eKim J, Song SW, Cho J-H, Chang K-H, Jun BC. Comparative study of the pneumatization of the mastoid air cells and paranasal sinuses using three-dimensional reconstruction of computed tomography scans. Surg Radiol Anat SRA 2010;32:593\u0026ndash;9. https://doi.org/10.1007/s00276-009-0618-4.\u003c/li\u003e\n\u003cli\u003eCohen O, Warman M, Fried M, Shoffel-Havakuk H, Adi M, Halperin D, et al. Volumetric analysis of the maxillary, sphenoid and frontal sinuses: A comparative computerized tomography based study. Auris Nasus Larynx 2018;45:96\u0026ndash;102. https://doi.org/10.1016/j.anl.2017.03.003.\u003c/li\u003e\n\u003cli\u003eThakur P, Potluri P, Kumar A, Tyagi AK, Kumar A, Varshney S, et al. Sphenoid Sinus and Related Neurovascular Structures\u0026mdash;Anatomical Relations and Variations on Radiology\u0026mdash;A Retrospective Study. Indian J Otolaryngol Head Neck Surg 2021;73:431\u0026ndash;6. https://doi.org/10.1007/s12070-020-01966-y.\u003c/li\u003e\n\u003cli\u003eAkbar Ali Md, Manish Jaiswal D, Sameer Ahamed DB, Kumari V, Alam S. A Study of Anatomical Variations of Sphenoid Sinus on CT PNS: Our Experience. Indian J Otolaryngol Head Neck Surg 2022;74:1690\u0026ndash;3. https://doi.org/10.1007/s12070-021-02842-z.\u003c/li\u003e\n\u003cli\u003eRad SAB, Anbiaee N, Moeini S, Bagherpour A. Sex Determination Using Human Sphenoid Sinus in a Northeast Iranian Population: A Discriminant Function Analysis. J Dent 2023;24:95. https://doi.org/10.30476/dentjods.2022.92915.1685.\u003c/li\u003e\n\u003cli\u003eAhmed J, Namrata SN, Sujir N, Shenoy N, Natarajan S, Muralidharan A, et al. A comparative analysis of sphenoid and frontal sinuses using cone beam computed tomography for sex determination. J Oral Biol Craniofacial Res 2024;14:478\u0026ndash;83. https://doi.org/10.1016/j.jobcr.2024.05.004.\u003c/li\u003e\n\u003cli\u003eHai-Yan L, Zi-Yang B, Wang J, Xiao-Fang Y, Tae-Geon K, Ke-Ming Y, et al. Application of Sphenoid Sinus Morphological Characteristics in Sex Estimation Based on Magnetic Resonance Imaging Images. Int J Morphol 2023;41:1166\u0026ndash;70. https://doi.org/10.4067/S0717-95022023000401166.\u003c/li\u003e\n\u003cli\u003eGibelli D, Cellina M, Gibelli S, Oliva AG, Codari M, Termine G, et al. Volumetric assessment of sphenoid sinuses through segmentation on CT scan. Surg Radiol Anat 2018;40:193\u0026ndash;8. https://doi.org/10.1007/s00276-017-1949-1.\u003c/li\u003e\n\u003cli\u003eHammer G, Radberg C. The sphenoidal sinus. An anatomical and roentgenologic study with reference to transsphenoid hypophysectomy. Acta Radiol 1961;56.\u003c/li\u003e\n\u003cli\u003eLiu H-Y, Bai Z-Y, Jing W, Yang X-F, Kwon T-G, Yun K-M, et al. Application of Sphenoid Sinus Morphological Characteristics in Sex Estimation Based on Magnetic Resonance Imaging Images. Int J Morphol 2023;41:1166\u0026ndash;70.\u003c/li\u003e\n\u003cli\u003eVidya KC, Devika V, Krishnan P. Assessment of sphenoid sinus volume for sexual dimorphism using CT. Indian J Otolaryngol Head Neck Surg 2018;70:549\u0026ndash;55.\u003c/li\u003e\n\u003cli\u003eKaya A, Ozcan I, Cankaya H. Morphometric evaluation of sphenoid sinus variation using CT in a Turkish population. Eur Arch Otorhinolaryngol 2019;276:2207\u0026ndash;14.\u003c/li\u003e\n\u003cli\u003eAl-Qudah MA. Developmental changes of the sphenoid sinus and its relationship to sella turcica. Ital J Anat Embryol 2014;119:245\u0026ndash;54.\u003c/li\u003e\n\u003cli\u003eAdeel M, Ikran M, Awan M, El-Shazly A. Relationship of the sphenoid sinus with surrounding neurovascular structures. J Coll Physicians Surg 2013;23:446\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eAnusha S, Kavitha B, Karthik V. CT evaluation of sphenoid sinus anatomy for endoscopic transsphenoidal surgery. Int J Res Med Sci 2015;3.\u003c/li\u003e\n\u003cli\u003eHewaidi G, Omami G. Anatomic variation of sphenoid sinus and their impact on related neurovascular structures. Surg Radiol Anat 2008;30:375\u0026ndash;80.\u003c/li\u003e\n\u003cli\u003eSirikci A, Bayazik YA, Gungor K. Variations of sphenoid sinus and surrounding structures. J Comput Assist Tomogr 2000;24:971\u0026ndash;6.\u003c/li\u003e\n\u003cli\u003eIgbinedion BO, Ogbole GI. Variation in sphenoid sinus pneumatization in adult Nigerians: CT-based study. Afr J Med Med Sci 2013;42:263\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eOyinloye OI, Adegbiji WA, Olatunji AA. Computed tomographic evaluation of sphenoid sinus anatomy among southwest Nigeria. Pan Afr Med J 2020;37:1\u0026ndash;9.\u003c/li\u003e\n\u003cli\u003eAdeleke AO, Ogunlade SO, Balogun BO. Morphometric variations of the sphenoid sinus among Nigerians using CT imaging. J Clin Anat 2021;34:110\u0026ndash;8.\u003c/li\u003e\n\u003cli\u003eAhmed RA, Hassan MA, El-Shazly A. Age-related changes in sphenoid sinus volume: A radiological study. Egypt J Otolaryngol 2020;36:1\u0026ndash;7.\u003c/li\u003e\n\u003cli\u003eOladipo GS, Okoh PD, Akande PA. Sex determination using sphenoid sinus dimensions in a Nigerian population. J Forensic Res 2017;8:1\u0026ndash;4.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"University of Port Harcourt","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Sphenoid sinus, CT scan, Pneumatization, Sellar, Morphometry","lastPublishedDoi":"10.21203/rs.3.rs-9555652/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9555652/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study examined the morphometric characteristics of the sphenoid sinus amongst Nigerians living in Port Harcourt using computed tomography (CT) imaging, focusing on gender and age-related variations.\u003c/p\u003e\n\u003cp\u003eA total of 200 retrospective CT scans of adults aged 18 - 70 years (100 males and 100 females) were reviewed. Participants were grouped into four age ranges: 18-25, 26-40, 41-55, and 56-70 years. Measurements of sinus height, width, depth, and volume were obtained using standard radiological software. Pneumatization patterns and neurovascular relations were also evaluated. deviation, while non-normally distributed data were summarized as median and interquartile range. Categorical variables were presented as frequencies and percentages. Independent t-tests were used to assess gender differences, one-way ANOVA to determine age-related variations, and chi-square tests for associations between categorical variables. Statistical significance was set at p \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003eThe values of height, width, depth, and volume in males were 24.6 ± 3.8 mm, 23.9 ± 4.1 mm, 18.0 mm, and 10.2 ± 3.4 cm³, respectively, while in females, 22.1 ± 3.4 mm, 22.1 ± 3.7 mm, 16.0 mm, and 8.6 ± 2.1 cm³, respectively.\u003c/p\u003e\n\u003cp\u003eThese results showed that males exhibited significantly larger sphenoidal sinus dimensions and volumes compared to females. It also showed significant variations in sinus volume and depth across age groups, peaking in the 41-55 age group before slightly decreasing in the oldest group.\u003c/p\u003e\n\u003cp\u003eThe sellar pneumatization type was the most common (54%), followed by postsellar (22%), presellar (18%), and conchal (6%). Internal carotid artery protrusion was seen in 14% of subjects, while optic nerve protrusion occurred in 9%, and both protrusions were more common in males. These findings highlight that sphenoid sinus morphology varies significantly with gender and age among Nigerians. The study emphasizes the clinical importance of preoperative CT evaluation to prevent neurovascular injury and provides reference data valuable to radiologists, surgeons, and forensic anatomists.\u003c/p\u003e","manuscriptTitle":"Morphometric Analysis of the Sphenoid Sinus in Sex Determination, Pneumatization Patterns, and Variant Neurovascular Relations Among Nigerian Citizens in Port Harcourt","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-29 06:40:54","doi":"10.21203/rs.3.rs-9555652/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"bc347ae7-226f-4b90-8063-be506198464e","owner":[],"postedDate":"April 29th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":67215184,"name":"Forensic Medicine"}],"tags":[],"updatedAt":"2026-04-29T06:40:54+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-29 06:40:54","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9555652","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9555652","identity":"rs-9555652","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}