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KMID : 0361020010440040399
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Korean Journal of Otolaryngology - Head and Neck Surgery
2001 Volume.44 No. 4 p.399 ~ p.404
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Intranasal Transethmoid Approach to the Sphenoid Sinus Ostium in Endoscopic Sinus Surgery: A Safe Technique Using the Superior Turbinate As a Key Landmark
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홍순관/Soon Kwan Hong
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Abstract
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Background and Objectives: Identification of the natural ostium verifies the safest entry to the sphenoid sinus (SS) in endoscopic sinus surgery (ESS). In order not to destabilize the middle turbinate (MT), new techniques have recently been
introduced
on transethmoid approaches to the SS ostium after ethmoidectomy. The aims of this study are to introduce an intranasal transethmoid approach to the SS ostium for sphenoidotomy using the superior turbinate (ST) as a key landmark without
destabilization
of the MT in ESS for chronic sinusitis with concurrent sphenoiditis and to determine its efficacy by evaluating the outcome of the patients. Materials and Methods: Fifty-three chronic sinusitis patients (37 males and 16 females, aged 14 to 63
years)
with concurrent sphenoiditis in one or both SSs and their 75 SSs were included in this study. Sphenoidotomy was performed in all patients. The SS ostium was identified just medial to the ST remnant. Number of SSs where the ostium was identified
was
determined, and surgical complications were evaluated. To assess olfactory changes, a butanol threshold test was performed before and after the surgery. Results: The SS ostium was identified in 73 (97.3%) of the 75 SSs. The preoperative threshold
(3.9±3.0) in the butanol test significantly improved to 5.1±2.5 after the operation in the 75 nasal sides. Olfactory function of only 3 (4.0%) sides worsened after surgery. There were no major complications in all patients. Conclusion: This
technique
may be an effective and safe approach to the SS ostium in ESS for chronic sinusitis with concurrent sphenoiditis without destabilization of the MT.
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KEYWORD
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