الفهرس 
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Abstract
This work studied sphenoidal sinus radiologically and vital neurovascular relations as ICA and ON also we studied the relation between these variations and septation pattern and type of pneumatization and we also studied the presence and absence of onodi cells and we compared our results with previous studies showing how vital to asses such information preoperative regarding trans nasal trans sphenoid endoscopic cranial surgery as it can dramatically decrease morbidity and mortality by avoiding injury of important structures and also how understanding of these variation to each case can give us much more successful sohenoidal and trans sphenoidal endoscopic sinus surgery Although there are a lot of reports about sphenoidal sinus radiological studies. We didn’t detect in the English puplished literatures , studies that consider all these variations as we considered in our study . As Endoscopic sinus surgeries(ESS) Aand trans sphenoidal approaches have been expanded at the last few decades it necessary for the ENT surgeon to be aware of the detailed meticulous anatomy of the sphenoid sinus and its variations, So, researching these variations provide vital information that will lead to much more successful trans sphenoidal sinus surgery (TSSS) and decrease complications of such surgeries in our study we assessed 210 cases for many vital informations of sphenoid sinus, and compared these informations to the previous reports . Our study showed that, sellar (adult) type of sphenoid sinus pneumatization is the most common type that presented (76.2%) followed by presellar (juvenile) type that presented in (22.9%) then conchal (fetal) type only in (0.95%). These results found to be in consistency of previous reports that reported the incidence of the sellar type sphenoid sinus in Lupascu et al. and hamid et al. to be 53-89 % , whereas the presellar type was declared as 10-38 % . Moreover, conchal type was found between 0 % and 9 % et al. 2016 reported that conchal pneumatization was registered in 2 %, presellar in 24 %, sellar in 41 % and postsellar in 33 % of total sinuses . ELKammash et al. reported that sellar type was the most frequent type of pneumatization (85.7 %) he also reported that the conchal type was seen in three cases (1.6 %) and presellar type (12.6 According to AfsounSeddighi.et al . sellar type represented (69.4%), presellar type (25.6%), and conchal type (5%).In a study by sareen et al . Sellar type is found to be the most frequent( 75% to 86% of cases) , followed by the presellar type ( 10% to 25%) , and only 2% of cases show conchal or fetal type. In our study we found pneumatization of ACP in 42 cases ( 20%) that was bilateral in 16 cases (7.6%),and unilateral in 26 cases (12.3%) 15 of them were on the right side (7.1%) and 11 of them were on the left side (5.2%), and not pneumatized in 168 (80%) these results found to be in consistence with other studies asThe incidence of pneumatization in the anterior clinoid processes(ACP) in literature by Budu et al. was between 11% and 29.3%.According to rahmati et al . 2016, pneumatization of the ACP was 33.1%, which was17.2%,in the study conducted by Kazkayasi et al in a study by Abozayed et al ,Pneumatization of the ACP was found in 62 of 648 patients (9.6%) including 32 (51.6%) men and 30 (48.4%) women. The age of these patients ranged from 21 to 82 years (mean, 41 ± 15.7 years). Pneumatization of the ACP occurred only on the left side in 14 cases (22.6%), only on the right side in 11 cases (17.7%), and bilaterally in 37 patients (59.7%).Pneumatization of greater wing of sphenoid in our was seen in 61 cases (29 %) , 36 cases (17.1%) were unilateral ( 19 cases were on the right side( 9%) and 17 cases were on the left side (8.1%)), 25 cases (11.9 %) were bilateral , while no pneumatization of the greater wing of sphenoid was in 149 cases (71%) . In astudy by ELkammash et al 2014 The greater wing pneumatization was found in (5.1%),and according to yekpe et al2018 study The greater wing pneumatization was found in 21% that was bilateral in 14% and unilateral in 7%. at thr right side was 3 % and 4% of them was at the left side. In our study single inter sphenoid septum was found in 119 cases (56.7%) ,and multiple septa found in 87 cases (41.4%)and no septa in 4 cases (1.9%).These result were similar to some reports and different for others due to wide variation of incidence regarding SS septation pattern. Multiple inter sinus septae or crests were found in 80% of cases in study .According to, at least one of the septa is inserted on the carotid canal in 87% of cases. CT reconstructions has shown the presence of only one sphenoid septum (main septum — MS) in 21.96% of the patients, which divided the sphenoid sinus into two sphenoid antra. In 78.04% of the patients, there were more than one sphenoid septum present in the posterior part of the sphenoid sinuses. A single inter sinus septum in sphenoid sinus had been reported by many studies with a wide variation of incidence of 18.2-95% In a study , 34 cases showed right deviated septum as dominant with 43.3 % incidence). Occurrence of accessory and /or multiple inter sphenoid septum varies from 4.5% to 81.8% and the present study also shows a low incidence of 16.7%.In another study single intersphenoid septum found in 67.5% and multiple septa found in 31%.In our study Onodi cells were present in 67 cases (32%) of whom 30 cases (14.3%) were bilateral , 25 cases (11.9%)were on the right side , while on the left side occurred in 12 cases (5.7 %) , and were absent in 143 (68.1%) and these results were in consistence with other studies In yazici study , onodi cells were present in 22.5% and abscent in 77.5 %. In mokhasanavisu study, onodi cells were found in 15.5% and abscent in 74.5%. Onodi cells were observed in 40.7% of cases on the right side and in 25.9% on the left side. In 33.4% of the patients, bilateral Onodi cells were present. Male/Female ratio was 24.5%/17.6%.