الفهرس 
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Abstract
Nowadays, the endonasal transsphenoidal approach is the most suitable and safest route to pituitary gland pathologies. The transsphenoidal approach represents the standard approach to the pituitary area due to its versatility. It is the least traumatic approach to the sella, avoiding brain retraction and providing an excellent visualization of the pituitary gland and structures related with. New radiological modalities made it easy to identify different anatomical landmarks within the sphenoid sinus, sella and important adjacent structures. CT imaging is typically the preferred modality for the assessment of bony skull base anatomy. MR imaging remains the gold standard for characterizing pathology of the sellar region and its effect on the sinus. Aim of this study: The study aim to evaluate the different anatomical variations of the sphenoid sinus and sella turcica and relation between them and adjacent structures, to show how these variations affected by the pituitary tumor. Method: This study is retrospective study of patients with pituitary tumor with inclusion and exclusion criteria in period between January 2016 and march 2019 at Mansoura university hospitals, Mansoura, Egypt. CT and MRI analyzed for sphenoid sinus variations and adjacent Neurovascular structures. Results: Onodi cell noticed in 27.6% of cases, Intersphenoid septum number, single septum in 82.9%,two septum detected in 4.2% and no septum detected in12.9% of cases, Intersphenoid septum site, 70% of cases attached to mid line and 18.2% into lateral wall on carotid sulcus. Optic canal dehiscence in 22.4% of cases, Foramen rotundum dehiscence in 6.5% of cases and Vidian canal dehiscence in 7.1% of cases. Optic nerve protrusion present in 7.6% of cases, maxillary nerve protrusion detected in 10%, Vidian nerve protrusion detected in 11.8% of cases, carotid artery protrusion detected in 18.2% of cases, carotid artery dehiscence detected in 27.6% of cases and intercarotid distance mean was 19.81±4.62 mm. Conclusion: adequate preoperative orientation with radiological details of sphenoid sinus, sella, and adjacent vital structures, surgery could be done with acceptable result and the least intraoperative complications.