Minimally invasive approaches to the sphenoid sinus

• Published in: Otolaryngology-head and neck surgery 2002-06, Vol.126 (6), p.635-641
• Main Authors: Gibbons, Mark D., Sillers, Michael J.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Child; Chronic Disease; Endoscopy - methods; Evaluation Studies as Topic; Female; Follow-Up Studies; Humans; Male; Middle Aged; Minimally Invasive Surgical Procedures - methods; Paranasal Sinus Neoplasms - diagnostic imaging; Paranasal Sinus Neoplasms - surgery; Patient Satisfaction; Retrospective Studies; Severity of Illness Index; Sphenoid Sinus; Sphenoid Sinusitis - diagnostic imaging; Sphenoid Sinusitis - surgery; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 0194-5998; 1097-6817
• DOI: 10.1067/mhn.2002.125759

Objective: We sought to develop an algorithm for surgical approaches to the sphenoid sinus. Study Design and Setting: Retrospective review was conducted of all patients who underwent a sphenoid sinusotomy by the senior author between July 1994 and August 2001. Results: The study population consisted of 141 patients, in whom 5 different surgical approaches were used: transseptal (47 [33.3%]), transnasal (19 [13.5%]), transethmoid (72 [51.1%]), transmaxillary (2 [1.42%]), and external (1 [0.7%]). Of the 47 transseptal approaches, 43 (91.5%) were for extirpation of a neoplasm. In contrast, 60 of 72 (83.3%) transethmoid procedures were for infectious/inflammatory disorders. An endoscopic approach was used for 7 of 8 (87.5%) skull base repairs. Four transsphenoid optic nerve decompressions were performed. The minor and major complication rates were 2.1% and 0.71%, respectively. Conclusions: The anatomic location of the pathologic process can guide the surgeon in selecting the most appropriate technique. Significance: Surgical treatment of sphenoid pathology can be safely and successfully performed through a variety of approaches. (Otolaryngol Head Neck Surg 2002;126:635-641.)