Pneumatization of the sphenoid sinus in children evaluated by magnetic resonance imaging

Previous studies concerned with the normal development of the sphenoid sinus have reported that the onset of initial pneumatization varies from 6 months to 4 years of life, and that the pneumatization is completed by 12 to 14 years of age. This study was designed to evaluate the age-related development of the sphenoid sinus pneumatization in children using magnetic resonance (MR) imaging technique. MR images of the sphenoid sinus in 152 children, ages 2 months to 163 months, were retrospectively reviewed. The degree of pneumatization was classified into four grades as 0, 1, 2, and 3 in axial images, and into five grades as 0, 1, 2, 3, and 4 in sagittal images. The numbers of grades were age-matched in the studied children. The pneumatized sphenoid sinus was identifiable as early as 2 months of age on axial image, and 4 months on sagittal image. Pneumatized sphenoid sinuses were identified in 100% of the subjects studied at the age of 3 years on axial image, and 6 years on sagittal image. All the children over 9 years old showed pneumatization of grade 2 or more both on axial and sagittal images. The results of this study may indicate that the sphenoid sinus begins and completes pneumatization earlier than previously described.