Sphenoidotomy

Because of the complex anatomic relations of the sphenoid, the surgical approach to this sinus was only introduced 100 years ago. There are three approaches to the sphenoid sinus: transethmoidal, transseptal, and transpalatal. We present a case report, and discuss surgical anatomy, with attention to the important anatomic relationship of the cavernous sinus and its contents. A variant of the classical, sublabial, transseptal approach is described as follows: a window is created in the face of the sphenoid. This approach is particularly applicable to the surgery of mucoceles and allows easy postoperative inspection of the sphenoid sinus.