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Objectives: We evaluated endoscopic transnasal
sphenoidotomy (ETNS) with or without ethmoidectomy
in patients with inflammatory sphenoid sinus disease
(ISSD).
Patients and Methods: A retrospective review was
conducted in 42 patients (17 males, 25 females; mean
age 41 years; range 17 to 67 years) who underwent
ETNS with (n=37) or without (n=5) ethmoidectomy for
ISSD. The disase was staged according to our staging
system based on computed tomography findings.
Results: Postnasal drainage was the most common
symptom (n=37, 88.1%). Chronic rhinosinusitis was
accompanied by sinonasal polyps in 25 patients
(59.5%). Five patients (11.9%) had isolated sphenoid
disease and 16 patients (38.1%) had unilateral disease.
Five patients (11.9%) had stage 1, 15 patients (35.7%)
had stage 2, and 22 patients (52.4%) had stage 3 disease.
Surgery involved 68 sides. Ethmoidectomy was
used in 63 sides of 37 patients, eight of whom required
a supplementary procedure. At least one complication
was seen in eight patients (19%), including severe perioperative
hemorrhage (n=2), early postoperative hemorrhage
(n=2), minor injuries to the lamina papyracea
(n=4), and synechiae (n=5).
Conclusion: In patients with isolated ISSD, the direct
approach to the sphenoid sinus by ETNS without ethmoidectomy
is a favorable technique, whereas ETNS
with ethmoidectomy is necessary for patients with
concurrent disease in other paranasal sinuses.