Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T20:03:54.408Z Has data issue: false hasContentIssue false
  • English
  • Français

Endoscopic approaches to benign sphenoid sinus lesions: development of an algorithm based on 13 years of experience

Published online by Cambridge University Press:  28 August 2014

A S Elhamshary ,
H E Romeh ,
M F Abdel-Aziz  and
S M Ragab
A S Elhamshary
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Tanta University Hospitals, Egypt
H E Romeh
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Tanta University Hospitals, Egypt
M F Abdel-Aziz
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Tanta University Hospitals, Egypt
S M Ragab*
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Tanta University Hospitals, Egypt
*
Address for correspondence: Dr Sameh M Ragab, Department of Otolaryngology, Tanta University Hospitals, Tanta, Egypt Fax: 0020 403 416 781 E-mail: sragab@doctors.org.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To develop an algorithm for selecting the optimal endoscopic approach for benign sphenoid lesions.

Methods:

Charts of 392 patients were reviewed and categorised according to disease nature and extent as follows: group 1 comprised isolated sphenoid sinus lesion cases, group 2 consisted of pansinus lesion cases and group 3 comprised lateral sphenoid recess lesion cases. Surgical approaches, difficulties and complications were noted.

Results:

A transnasal approach was employed in 40.8 per cent of cases (23.2 per cent were group 1 patients, 16.1 per cent were group 2 patients and 1.5 per cent were group 3 patients), a transethmoidal approach was utilised in 54.3 per cent of cases (group 2 patients) and a transpterygopalatine fossa approach was selected in 4.9 per cent of cases (group 3 patients). Surgical difficulties were encountered in 11.9, 10.8 and 0 per cent of patients in whom transnasal, transethmoidal or transpterygopalatine approaches were utilised, respectively.

Conclusion:

Radio-pathological categorisation provided a means of developing an algorithm for selecting the most appropriate endoscopic approach. Transnasal sphenoidotomy should be the first choice of approach whenever applicable. Lateral sphenoid recess non-inflammatory diseases should be managed through a transpterygopalatine fossa approach. Revision surgery does not play a key role in the algorithm.

Keywords

Sphenoid SinusEndoscopyEndoscopic Surgical Procedures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 9 , September 2014 , pp. 791 - 796
Copyright
Copyright © JLO (1984) Limited 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Wyllie, JW, Kern, EB, Djalilian, M. Isolated sphenoid sinus lesions. Laryngoscope 1973;83:1252–65Google Scholar
2Gibbons, MD, Sillers, MJ. Minimally invasive approaches to the sphenoid sinus. Otolaryngol Head Neck Surg 2002;126:635–41Google Scholar
3Metson, R, Gliklich, RE. Endoscopic treatment of sphenoid sinusitis. Otolaryngol Head Neck Surg 1996;114:736–44Google ScholarPubMed
4Wigand, ME. Endoscopic Surgery of the Paranasal Sinuses and Anterior Skull Base. Stuttgart: Thieme, 1990Google Scholar
5Al-Nashar, IS, Carrau, RL, Herrera, A, Snyderman, CH. Endoscopic transnasal transpterygopalatine fossa approach to the lateral recess of the sphenoid sinus. Laryngoscope 2004;114:528–32Google Scholar
6Friedman, A, Batra, PS, Fakhri, S, Citardi, MJ, Lanza, DC. Isolated sphenoid sinus disease: etiology and management. Otolaryngol Head Neck Surg 2005;133:544–50Google Scholar
7Kieff, DA, Busaba, N. Treatment of isolated sphenoid sinus inflammatory disease by endoscopic sphenoidotomy without ethmoidectomy. Laryngoscope 2002;112:2186–8Google Scholar
8Stammberger, H. Functional Endoscopic Sinus Surgery: The Messerklinger Technique. Philadelphia: BC Decker, 1991Google Scholar
9Orlandi, RR, Lanza, DC, Bolger, WE, Clerico, DM, Kennedy, DW. The forgotten turbinate: the role of the superior turbinate in endoscopic sinus surgery. Am J Rhinol 1999;13:251–9Google Scholar
10Say, P, Leopold, D, Cochran, G, Smith, L, Greiner, T. Resection of the inferior superior turbinate: does it affect olfactory ability or contain olfactory neuronal tissue? Am J Rhinol 2004;18:157–60Google Scholar
11Schmidt, RF, Choudhry, OJ, Raviv, J, Baredes, S, Casiano, RR, Eloy, JA et al. Surgical nuances for the endoscopic endonasal transpterygoid approach to lateral sphenoid sinus encephaloceles. Neurosurg Focus 2012;32:1–8CrossRefGoogle ScholarPubMed
12Bolger, WE. Endoscopic transpterygoid approach to the lateral sphenoid recess: surgical approach and clinical experience. Otolaryngol Head Neck Surg 2005;133:20–6Google Scholar