Transseptal approach in endoscopic sphenoidotomy

Abstract

INTRODUCTION. Isolated sphenoid sinus disease is a rare condition due to the topographic location of the sinus. In complicated cases and the occurrence of a chronic course, the main method of treatment is surgical cure. There are different approaches to the main sinus, the most effective and safest is endoscopic endonasal sphenotomy. However, in cases of anomalies or disorders of the development of the sphenoid sinuses, as well as the need for combined operations, the transeptal approach may be the method of choice.OBJECTIVE is to evaluate the effectiveness and security of the proposed access.METHODS AND MATERIALS. A prospective analysis was carried out of 52 patients who underwent surgical treatment of isolated sphenoiditis at the Clinic of Otorhinolaryngology of the Pavlov State Medical University in the period from 2018 to 2023.RESULTS. In 5 cases, the sphenoid sinus was opened by transseptal approach. As a result of the analysis of the two approaches, no statistically significant differences were found.CONCLUSIONS. Our surgical interventions with transseptal approach in patients with minor sphenoid sinuses, impaired course of the internal cerebral artery, as well as the need for simultaneous correction of the nasal septum revealed the advisability and effectiveness of approach in such situations, as well as its safety in relation to neurovascular structures.