# Evaluation of the Relationship Between Zygomatic Process and Sphenoid Sinus Pneumatization in Cone-Beam Computed Tomography Images

## TL;DR

This study finds a strong link between zygomatic process pneumatization and sphenoid sinus pneumatization using 3D cone-beam CT scans.

## Contribution

The study introduces a detailed classification system for sphenoid sinus pneumatization and identifies a novel morphological correlation with zygomatic process pneumatization.

## Key findings

- Zygomatic process pneumatization was present in 64.0% of participants and correlated significantly with sphenoid sinus pneumatization.
- Postsellar type was the most common sphenoid sinus pneumatization (55.5%), while conchal was the rarest (1.2%).

## Abstract

Background/Objectives: Current evidence regarding the association between the temporal bone and paranasal sinus pneumatization remains limited. This study aims to investigate the potential morphological association between zygomatic process pneumatization and sphenoid sinus pneumatization using three-dimensional cone-beam computed tomography. Methods: Cone-beam computed tomography images from 573 individuals aged 16 to 87 years (170 males, 403 females) were evaluated in this study. Zygomatic process pneumatization was assessed in two forms: pneumatized glenoid fossa (a radiolucent defect on the glenoid fossa roof) and pneumatized articular eminence (a radiolucent defect within the articular eminence). The sphenoid sinus was classified into four major pneumatization types: conchal, presellar, sellar, and postsellar. The postsellar configuration was additionally divided into four subtypes—subdorsal, dorsal, occipital, and combined—according to its posteroanterior orientation. Lateral sphenoid sinus pneumatization was categorized into pterygoid, greater wing, full lateral (combining pterygoid and greater wing), lesser wing, and anterior types. Results: The analysis revealed a significant relationship between zygomatic process pneumatization and sphenoid sinus pneumatization (p < 0.001), where the former was detected in 64.0% of participants. The postsellar type represented the most frequent form of sphenoid sinus pneumatization (55.5%), whereas the conchal type was the rarest (1.2%). Conclusions: A significant correlation was observed between the zygomatic process and sphenoid sinus pneumatization, with individuals exhibiting the former tending to display more extensive sphenoid sinus pneumatization