The transsphenoethmoid approach to the sphenoid sinus and clivus.
Surgical access to the sphenoid sinus and clivus for the resection of benign and malignant disease is difficult and is often associated with significant morbidity. The transsphenoethmoid approach, an extension of a familiar otolaryngological procedure, with or without a limited medial maxillectomy, allows access to this region with little morbidity and excellent cosmetic results. Since 1988, the transsphenoethmoid approach has been used in 15 patients at our institution for resection of primary and recurrent chordomas, chondrosarcomas, pituitary macroadenomas, repair of cerebrospinal fluid leaks, and drainage of petroclival cysts. In most instances, an ipsilateral approach is most satisfactory. When necessary, a contralateral transsphenoethmoid approach is used when the tumor is posterolateral to the internal carotid artery and as far lateral as the abducens nerve.
Lalwani
A K
AK
Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of California, San Francisco.
Kaplan
M J
MJ
Gutin
P H
PH
D000236:Adenoma / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D001918:Brachytherapy; D002648:Child; D002813:Chondrosarcoma / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery; D002817:Chordoma / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D005004:Ethmoid Bone / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery; D009460:Neurologic Examination; D010255:Paranasal Sinus Neoplasms / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000532:radiotherapy / Q000601:surgery*; D012086:Reoperation; D013100:Sphenoid Bone / Q000601:surgery*; D013101:Sphenoid Sinus / Q000601:surgery*
D007457:Iodine Radioisotopes