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

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%).