Endoscopic surgery with powered instrumentation for isolated sphenoid sinus disease.
OBJECTIVE
Isolated sphenoid sinus disease (ISSD) is a relatively uncommon disease. In this study, we investigate the diagnosis and pathology of ISSD and compare endoscopic treatment with powered instrumentation with conventional surgical instruments for ISSD.


METHODS
Ninety-six out of 2,263 patients who underwent endoscopic surgery were diagnosed with ISSD by nasal endoscopy and computed tomography scan. Ninety-six cases of confirmed ISSD were treated by endoscopic sphenoidotomy, of which 44 cases were operated using powered instrumentation and 52 using conventional instruments. All patients were followed up for a period ranging from 18 to 54 months (mean 26 months) and the surgical outcomes were retrospectively reviewed.


RESULTS
The pathological findings of these patients included sphenoid sinusitis, fungal disease, sphenoid cyst, inverted papilloma, malignant tumor, sphenoid polyp, and foreign body. The most common initial symptom was headache, followed by visual changes and nasal symptoms. After endoscopic surgery, drainage of the sphenoid was accomplished in 87 of the 96 patients (91%). Of all patients, 9.4% (9/96) had recurrent incidence, 22% (21/96) sphenoid ostium synechia, and 51% (49/96) partial middle turbinectomy. Comparing the surgical outcomes between two operative approaches, recurrent incidence, sphenoid ostium synechia, and partial middle turbinectomy were significantly lower in the powered instrumentation group (2, 7, and 14%) than in the conventional instrument group (15, 35, and 83%;p < 0.05). No serious complication occurred in either group.


CONCLUSIONS
Powered instrumentation is more effective than conventional instruments in the treatment of ISSD and provides a minimally invasive surgical approach to the sphenoid sinus.
Yu
Hongmeng
H
Department of Otolaryngology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.
Li
Huawei
H
Chi
Fanglu
F
Dai
Chunfu
C
Zhang
Chonghua
C
Wang
Zhengmin
Z
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D012189:Retrospective Studies; D013101:Sphenoid Sinus / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome