[Sphenoidotomy—the treatment of patients with isolated sphenoid sinus diseases]

Zbigniew Kozłowski, Marcin Mazerant, Wojciech Skóra, Katarzyna Dabrowska
Otolaryngologia Polska 2008, 62 (5): 582-6

INTRODUCTION: The standart terms and definitions for paranasal sinuses operations were published in 2005 by Simmen and Jones. Sphenoidotomy is a surgical procedure when the natural ostium of sphenoid sinus is enlarged in varying degrees. Microscopic, endoscopic or ballon-assisted endoscopic sphenoidotomy are performed in endonasal sinus surgery and endonasal neurosurgery. This approach is considered for cases of isolated lesions of the sphenoid sinus, the sella lesions, the cerebrospinal fluid leaks into the sphenoid sinus and also for the treatment pathological conditions in the skull base. Isolated lesions of the sphenoid sinus are very rare with uncharacteristic symptoms. Headache is the most common. Vision disturbances occur occasionally. Endoscope assisted physical examination and CT scans of paranasal sinuses are necessary to make a diagnose.

MATERIAL AND METHODS: 5 patients suffering from the isolated sphenoid sinus lesion were diagnosed and treated at the Otolaryngology Department of Medical University of Lodz in 2007. Clinical data of these patients were analysed retrospectively. 4 underwent the transnasal endoscopic sphenoidotomy. There were 3 patients with chronic sinusitis, 1 with pyocele. 1 patient didn't agree for the operation.

RESULTS: All treated patients noted improvement in the preoperative symptoms. There were no complications during and after the operation.

CONCLUSIONS: Endoscopic sphenoidotomy is an effective and safe method of treatment of the isolated sphenoid sinus diseases. Nasal endoscopy and CT imaging are necessary for a precise diagnosis and treatment decision.

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