Treatment of isolated sphenoid sinus inflammatory disease by endoscopic sphenoidotomy without ethmoidectomy.
OBJECTIVE
Isolated chronic sphenoid sinusitis is a rare entity. The study was conducted to determine the efficacy of endoscopic sinus surgery with partial middle turbinectomy and without ethmoidectomy in treating isolated sphenoid opacification from inflammatory and infectious disease.


METHODS
Case series of 20 patients generated by retrospective review of 307 consecutive patients who underwent surgical treatment for chronic rhinosinusitis.


METHODS
The medical records were reviewed for pertinent demographic, symptom, radiographic, and endoscopic data preoperatively, interoperatively, and postoperatively. All patients in the series underwent computed tomographic image-guided endoscopic sphenoid sinus surgery with partial middle turbinectomy.


RESULTS
The study population consisted of 12 male and 8 female patients between 28 and 75 years of age. Headache (15 patients) and/or postnasal drip (14 patients) were the presenting symptoms in 17 of the patients. Three patients were asymptomatic. Surgical findings included inspissated secretions (15 patients), fungal debris (2 patients), and mucopyoceles (3 patients). The 17 patients with preoperative symptoms were symptom free by 12 weeks postoperatively and have remained so with follow-up ranging from 12 months to 3.25 years (mean follow-up, 23.1 mo). There were no operative complications in the series.


CONCLUSIONS
Endoscopic sphenoid sinus surgery without ethmoidectomy is effective for treating isolated sphenoid sinus opacification associated with inflammatory or infectious sinus disease. Partial middle turbinectomy at the time of surgery facilitates the approach, as well as postoperative cleaning and surveillance.
Kieff
David A
DA
Department of Otolaryngology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston 02114, USA. david_kieff@vmed.org
Busaba
Nicholas
N
D000328:Adult; D000368:Aged; D004724:Endoscopy; D005004:Ethmoid Bone / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013100:Sphenoid Bone / Q000601:surgery*; D013101:Sphenoid Sinus / Q000601:surgery*; D015524:Sphenoid Sinusitis / Q000601:surgery*; D013997:Time Factors; D014420:Turbinates / Q000601:surgery