The Optic Strut—CBCT Pneumatization Pattern and Prevalence

(1) Background: The optic strut (OS) is a critical landmark for clinoid and paraclinoid surgical interventions. To our knowledge, the current literature only mentioned the OS as a possibility for a lesser sphenoidal wing (LSW) pneumatization path, without a proper study of the pneumatization patterns and prevalence within this structure. Thus, our aim was to fill in the missing information. (2) Methods: A retrospective study on 80 cone beam computed tomography (CBCT) files was conducted to assess the prevalence and the origins of pneumatization within the OS. (3) Results: The pneumatization patterns of the OS were: 56.25% from the sphenoid sinus, 1.25% from the posterior ethmoid air cells (PEAC), and 10% from Onodi cells (ONC). Simultaneous pneumatization of unique origin within the lesser sphenoidal wing (LSW) was found in 26.25% from the sphenoid sinus, 1.25% from PEAC, and 5% from ONC. Communication between both LSW roots through pneumatization was found in 6.25% of the files. (4) Conclusions: A careful radiological examination should precede clinical diagnosis and surgical interventions in the paraclinoid area to evaluate postoperative surgical risks and possible diffusion patterns for infection. Additionally, pneumatization within the OS alters its morphological features and thus, its utility as a landmark.