Pneumatization types of the dorsum sellae: a computed tomography study

The present work aimed to classify the pneumatization of the dorsum sellae (DS) in subjects aged 1–90 years.

The study consisted of computed tomography images of 1080 subjects (582 males / 498 females), aged 1–90 years (mean age: 45.51 ± 26.06 years). Four different types regarding DS pneumatization were defined as follows: Type 0: no pneumatization, Type 1: pneumatization < 50%, Type 2: pneumatization > 50%, and Type 3: total pneumatization.

DS pneumatization was identified in 354 (32.8%) subjects (189 males and 165 females). Its pneumatization was identified in 51 (21.2%) out of 241 children, and 303 (36.1%) out of 839 adults. The frequency of DS pneumatization types was found as follows: Type 0 (no pneumatization in 726 subjects, 67.2%) > Type 1 (pneumatization < 50% in 234 subjects, 21.6%) > Type 2 (pneumatization > 50% in 87 subjects, 8.1%) > Type 3 (total pneumatization in 33 subjects, 3.1%). DS pneumatization incidence was affected by ages (p < 0.001), but not sex (p = 0.818). The pneumatization degrees of DS (i.e., the distributions of Types 1–3) were not affected by ages (p = 0.637) or sex (p = 0.391).

The pneumatization incidence of DS increased significantly with advancing adult ages (especially in elderly people). DS pneumatization should be taken into account by neurosurgeons and neuroradiologists to decrease the risk of complications such as cerebrospinal fluid fistula during surgeries such as posterior clinoidectomy.