Endoscopic transnasal sphenoidotomy with or without ethmoidectomy.
OBJECTIVE
We evaluated endoscopic transnasal sphenoidotomy (ETNS) with or without ethmoidectomy in patients with inflammatory sphenoid sinus disease (ISSD).


METHODS
A retrospective review was conducted in 42 patients (17 males, 25 females; mean age 41 years; range 17 to 67 years) who underwent ETNS with (n=37) or without (n=5) ethmoidectomy for ISSD. The disase was staged according to our staging system based on computed tomography findings.


RESULTS
Postnasal drainage was the most common symptom (n=37, 88.1%). Chronic rhinosinusitis was accompanied by sinonasal polyps in 25 patients (59.5%). Five patients (11.9%) had isolated sphenoid disease and 16 patients (38.1%) had unilateral disease. Five patients (11.9%) had stage 1, 15 patients (35.7%) had stage 2, and 22 patients (52.4%) had stage 3 disease. Surgery involved 68 sides. Ethmoidectomy was used in 63 sides of 37 patients, eight of whom required a supplementary procedure. At least one complication was seen in eight patients (19%), including severe perioperative hemorrhage (n=2), early postoperative hemorrhage (n=2), minor injuries to the lamina papyracea (n=4), and synechiae (n=5).


CONCLUSIONS
In patients with isolated ISSD, the direct approach to the sphenoid sinus by ETNS without ethmoidectomy is a favorable technique, whereas ETNS with ethmoidectomy is necessary for patients with concurrent disease in other paranasal sinuses.
Erylmaz
Adil
A
Department of Otolaryngology, Ankara Numune Hospital, Ankara, Turkey.
Dursun
Engin
E
Saylam
Güleser
G
Göçer
Celil
C
Dağli
Muharrem
M
Korkmaz
Hakan
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D004724:Endoscopy; D005004:Ethmoid Bone / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015524:Sphenoid Sinusitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome