How important is the Sphenoseptal cell in identifying the skull base? Recent incidence and demonstration of endoscopic surgical steps

Background/aim:Because of close relations to important anatomical structures such as cavernous sinus and optic nerve, sphenoid sinus variations must be well trained by the otolaryngologist who has an interest in endoscopic sinus surgery. Newly defined sphenoseptal cell (SSC) is one of those variations that may lead to insufficient endoscopic sinus surgery outcomes if not defined preoperatively with imaging studies. The present study aimed to present the main characteristics of this special type of nasal cell. Materials and methods:In this study, 610 paranasal sinus CT scans were analyzed and reviewed retrospectively between May 2018 and December 2019. Also, endoscopic findings of SSC that cause a surgical catastrophe in identifying skull base and sella are presented during transnasal transsphenoidal pituitary surgery. Results:According to its definition and relation to the sphenoid sinus and the skull base, an SSC was seen in 21 scans of 610 patients (3.4%), 11 were women (55%) and 10 were men (45%). Conclusion:Although an SSC is a rare variation of nasal air cells, preoperative diagnosis of this cell is of paramount importance in some patients during endoscopic transnasal surgery for the identification of skull base.