The management of 53 non-pituitary lesions in sphenoidal sinus by transnasal endoscopic surgery / 临床耳鼻咽喉头颈外科杂志

ABSTRACT

OBJECTIVE@#To investigate the diagnosis and management of non-pituitary lesions in sphenoidal sinus.@*METHOD@#All cases with non-pituitary lesions in sphenoidal sinus were confirmed by CT scan. Eight cases with localized lesions underwent operation by trans-sphenoidal approach. Two cases with juvenile nasopharyngeal angiofibroma with invasion to the sphenoid sinus were treated by trans-septal approach. The rest received operation by trans-superior meatal or trans-ethmoidal approach.@*RESULT@#Forty-five of these cases underwent complete or major resection of the lesion by endoscopic sphenoid sinus surgery, including 23 cyst and pus cyst of sphenoidal sinus, 8 fungal sphenoid sinusitis, 2 bleeding polyp of sphenoidal sinus, 1 post- hypophysectomy granulation hyperplasia of sphenoidal sinus , 5 papilloma of sphenoid sinus, 1 cerebrospinal rhinorrhea of sphenoid sinus, 2 ossified fibroma of sphenoid sinus,2 juvenile nasopharyngeal angiofibroma with invasion to the sphenoid sinus, 1 meningioma of ethmoid and sphenoid sinus. Three cases with hematoma in sphenoidal sinus and pseudoaneurysm in internal carotid artery underwent nasal endoscopic examination, and the diagnosis was established by DSA, and they received interventional therapy. Three cases with malignancy of sphenoidal sinus received major mass resection of sphenoidal sinus by trans-ethmoidal approach, and followed with radio therapy and chemotherapy. Two cases with NPC involving sphenoidal sinus were treated by radio therapy and chemotherapy after pathological examination.@*CONCLUSION@#Headache and visual loss were two common symptoms for the lesions in sphenoidal sinus. Imaging study including CT, MRI and DSA is very important for the diagnosis of the lesions in sphenoidal sinus. There are various surgical pathways to deal with sphenoidal sinus diseases under nasal endoscope. The operation will be direct, safe and minimal invasive if we choose the pathway properly.