External (combination) rhinoplasty approach for trans-sphenoidal adenectomy

Area of Science:

• Otolaryngology
• Neurosurgery
• Plastic Surgery

Background:

• Trans-sphenoidal adenomectomy is a common surgical procedure.
• The external rhinoplasty approach and sublabial approach are utilized for this surgery.
• Comparing these two approaches is essential for surgical optimization.

Purpose of the Study:

• To summarize experience with the external rhinoplasty technique for trans-sphenoidal adenomectomy.
• To compare the external rhinoplasty approach with the sublabial approach for this procedure.

Main Methods:

• Retrospective review of 10 patients undergoing trans-sphenoidal adenomectomy via external rhinoplasty.
• Comparison with 12 patients who underwent the sublabial approach.
• Evaluation of surgical access, exposure, and concurrent procedures.

Main Results:

• The external rhinoplasty approach decreased the distance to the sphenoid sinus, enhancing instrumentation.
• This technique allowed wider exposure with the Hardy speculum.
• Synchronous cosmetic/reconstructive septorhinoplasty was feasible.
• The approach proved valuable for revision surgeries, especially after prior sublabial procedures.
• Disadvantages included an external columellar incision and temporary nasal tip edema.

Conclusions:

• The external rhinoplasty approach provides significant advantages for trans-sphenoidal adenomectomy, including improved access and versatility.
• It is particularly useful for complex cases and revision surgeries.
• While a minor external scar and temporary edema are noted, the benefits outweigh these drawbacks.