Minimally invasive approaches to the sphenoid sinus.
OBJECTIVE
We sought to develop an algorithm for surgical approaches to the sphenoid sinus.


METHODS
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.


CONCLUSIONS
Surgical treatment of sphenoid pathology can be safely and successfully performed through a variety of approaches.
Gibbons
Mark D
MD
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, 35249-6889, USA. mark.gibbons@ccc.uab.edu
Sillers
Michael J
MJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002908:Chronic Disease; D004724:Endoscopy / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D010255:Paranasal Sinus Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013101:Sphenoid Sinus; D015524:Sphenoid Sinusitis / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome