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Surgical approaches to the sphenoid sinus
D K Cheung1, G F Martin, J Rees
1Department of Otolaryngology, Dalhousie University, Halifax, Nova Scotia.
The Journal of Otolaryngology
|February 1, 1992
Summary
Safely accessing the sphenoid sinus requires understanding the anatomy of the ethmoid, nasal, and septal zones. Knowledge of variations and disease impact is crucial for preventing complications during surgical approaches.
Area of Science:
- Otorhinolaryngology
- Surgical Anatomy
Background:
- The sphenoid sinus is a complex anatomical structure.
- Accessing the sphenoid sinus involves navigating through specific zones of its anterior wall.
Purpose of the Study:
- To define the anatomical conditions for safe penetration of the ethmoid, nasal, and septal zones of the sphenoid sinus.
- To correlate anatomical variations and disease characteristics with optimal surgical approaches.
Main Methods:
- Review of case studies.
- Examination of fresh and fixed cadaveric material.
- Radiologic examinations, including 3D CT reconstructions.
Main Results:
- The ethmoid zone presents risks due to common anatomical variations like ethmoid cell placement.
- The transnasal route is suitable for isolated sphenoid disease, but nasal pathology can cause bleeding.
- The septal zone offers advantages, particularly when considering the vomer-ethmoid relationship.
Conclusions:
- Optimal sphenoid sinus entry depends on the specific disease and requires detailed anatomical knowledge.
- Radiological mapping is essential for identifying normal and aberrant anatomy to prevent surgical complications.