TITLE:
Anatomical Variability of the Sphenoid Sinus in Côte d’Ivoire and Its Relevance to Transsphenoidal Surgery: A Descriptive and Analytical Morphometric CT Study
AUTHORS:
Soress Dongo, Louis Derou, Landry Teti, Bernard Fionko, Jean-Baptiste Keke, Jean Jacques Kouassi, Espérance Broalet
KEYWORDS:
Sphenoid Sinus, Pneumatization, Morphometry, Computed Tomography, Transsphenoidal Surgery, Côte d’Ivoire
JOURNAL NAME:
World Journal of Neuroscience,
Vol.16 No.4,
October
27,
2026
ABSTRACT: Background: The sphenoid sinus is highly variable, which conditions the safety of the transsphenoidal approach, yet morphometric data remain scarce in sub-Saharan Africa. Objective: To describe the morphological and morphometric characteristics of the sphenoid sinus in an Ivorian population and to investigate the associations between the type of pneumatization and demographic and anatomical parameters. Methods: Retrospective descriptive and analytical study of the cranial CT scans of 150 Ivorian adults aged 20 years or over, selected consecutively from 184 examinations performed at the Radiology Department of the Bouaké Regional Hospital Center between March and June 2026. Pneumatization was classified according to Hammer and Radberg and the sella turcica according to Axelsson; each scan was read in consensus by a neurosurgeon and a radiologist using predefined criteria for protrusion and dehiscence. Associations were tested with chi-square or exact tests, distances were compared between sexes (Welch t test, with Mann-Whitney U test as sensitivity analysis) and correlated with age (Spearman), and effect estimates are given with 95% confidence intervals (CI). Results: Mean age was 39.3 ± 13.9 years (sex ratio 1.83). Sellar (40.0%) and postsellar (36.7%) pneumatization predominated (together 76.7%), followed by the presellar (21.3%) and conchal (2.0%) types. A septation was present in 96.0% of patients and internal carotid artery (ICA) and/or optic nerve variants in 44 (29.3%). ICA protrusion occurred only in sellar (6.7%) and postsellar (20.0%) sinuses, a risk difference of 13.0 percentage points (95% CI 2.0 to 20.4) compared with the presellar and conchal types (p = 0.012); this association did not withstand correction for multiple testing. The nasal orifice-sphenoid sinus distance was longer in men (mean difference 5.6 mm, 95% CI 4.0 to 7.3) and the sinus superior edge-ostium distance longer in women (1.1 mm, 95% CI 0.3 to 2.0); a smaller difference in sinus depth (1.2 mm, 95% CI 0.1 to 2.3) did not withstand correction for multiple testing. No distance was correlated with age (all |ρ| Conclusion: In this series, most sphenoid sinuses showed sellar or postsellar pneumatization, which offers a potentially favorable bony corridor for the transsphenoidal approach; postsellar sinuses, however, concentrated ICA protrusion. These single-center data provide a local imaging reference and do not replace a patient-specific preoperative CT assessment.