title: Role of the superior turbinate when performing endoscopic endonasal transsphenoidal approach.
abstract: BACKGROUND
  This study examined the relationship between the superior turbinate and natural ostium of the sphenoid sinus, as seen during the endoscopic endonasal transsphenoidal approach (EETSA) for sellar lesions and described how to enter the sphenoethmoid cell safely for complete exposure of the sellar floor, including adjacent vital structures such as the prominence of the optic nerve and carotid artery.
  
  
  METHODS
  This study retrospectively reviewed the medical records and operative findings of 154 patients, who underwent EETSA between February 2009 and February 2011. We evaluated the location of the natural ostium of the sphenoid sinus relative to the superior turbinate and revealed the clinical significance of the superior turbinate as a surgical guide to enter into the sphenoethmoid cell during EETSA.
  
  
  RESULTS
  The natural ostium of the sphenoid sinus was located medially to the posteroinferior end of the superior turbinate in 151 (98%) patients. In 1 patient, the natural ostia of the sphenoid sinus were located lateral to the superior turbinate bilaterally. Sphenoethmoid cell was encountered in 53 (34%) patients. We could easily enter the sphenoethmoid cell at the point where the superior turbinate was attached to the anterior wall of the sphenoid sinus.
  
  
  CONCLUSIONS
  The superior turbinate is a good surgical landmark for identifying the natural ostium of the sphenoid sinus and as a guide for the surgical entrance to the sphenoethmoid cell extending to the sphenoid sinus during EETSA.
authors.forename: J-H
authors.initials: JH
authors.lastname: Shin
authors.forename: S G
authors.initials: SG
authors.lastname: Kang
authors.forename: Y K
authors.initials: YK
authors.lastname: Hong
authors.forename: S S
authors.initials: SS
authors.lastname: Jeun
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, The Catholic University of Korea, College of Medicine, Seoul, Korea. kswent@catholic.ac.kr.
authors.forename: S W
authors.initials: SW
authors.lastname: Kim
authors.forename: S W
authors.initials: SW
authors.lastname: Kim
authors.forename: J H
authors.initials: JH
authors.lastname: Cho
authors.forename: Y J
authors.initials: YJ
authors.lastname: Park
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013101:Sphenoid Sinus / Q000601:surgery*; D014420:Turbinates / Q000601:surgery*