Introduction:Asymmetrically divided sphenoid sinuses exhibits a variety of variation in the presentation of inter sinus septum. Previous reported range of incidence of single midline inter-sphenoid sinus septum is from 18.2% to 95%. Many studies have reported differing incidences of laterally placed septum, accessory septa, multiple septa, transverse septa and no septum in the sphenoid sinuses. Termination of inter-sphenoid septum either into internal carotid canal or into optic canal had also been shown in many studies with possibilities of high risk complications related to such termination of septum. As there exists only limited data in Indian ethnicity about the variations in presentation of inter-sphenoid sinus septum compounded by the relative high frequency of occurrence of endoscopic trans sphenoid microsurgeries, this study was done to observe variations occurring in septum of sphenoid sinuses. Materials and Methods:A retrospective CT analysis of images obtained from 114 patients diagnosed with sinusitis during a specific study period was done by two independent observers. The age of the patients ranged from 16 -60 years of both sexes. Patients with history of prior sinus or sphenoid surgery, facial trauma, obscured sphenoid sinus pathology were excluded. Results:Single inter sphenoid sinus septum was seen in 83.3% .Out of this Midline, right deviation, left deviation were observed in 11.4%, 33.9% and 21.9% respectively. In 16.7 % images accessory/ multiple septum were noticed. While, absent inter sphenoid septum and transverse septum were noted each in 0.8% of images studied. The termination of inter sinus septum to internal carotid canal occurred in 27.3% and into optic canal in 48% of all images studied. Conclusion:This study concluded that the variation in the presentation of inter-sphenoid septum and its termination at internal carotid artery canal or optic canal need to be pre operatively evaluated by surgeons for considering risk of septal resection during Trans-sphenoid endoscopic surgeries.

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