Retrospective Analysis of Surgical Treatment in Isolated Sphenoid Sinus Disease

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  • Hayama Masaki
    Department of Otorhinolaryngology—Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Shikina Takashi
    Department of Otorhinolaryngology—Head and Neck Surgery, Osaka University Graduate School of Medicine Department of Otorhinolaryngology, Ikeda Municipal Hospital
  • Nishiike Suetaka
    Department of Otorhinolaryngology—Head and Neck Surgery, Osaka Rosai Hospital
  • Masumura Chisako
    Department of Otorhinolaryngology, Suita Municipal Hospital
  • Ohta Yumi
    Department of Otorhinolaryngology—Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Maeda Youhei
    Department of Otorhinolaryngology—Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Takeda Kazuya
    Department of Otorhinolaryngology—Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Okazaki Suzuyo
    Department of Otorhinolaryngology—Head and Neck Surgery, Osaka University Graduate School of Medicine
  • Inohara Hidenori
    Department of Otorhinolaryngology—Head and Neck Surgery, Osaka University Graduate School of Medicine

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  • 孤立性蝶形骨洞病変に対する手術治療の臨床的検討

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<p>Isolated sphenoid sinus disease (ISSD) is relatively rare. A retrospective analysis of 38 cases is reported. The study population included 21 males and 17 females with a median age of 64.0 years (range, 12–85 years). There were 14 patients with inflammatory disease, 11 with cystic disease, 8 with fungal sinusitis, and 5 with tumors.</p><p>There are several surgical approaches that can be used to treat ISSD, including the trans-ethmoid, trans-nasal, and trans-septal approaches. Among our cases, 18, 14, and 6 were treated via the trans-nasal, trans-septal, and trans-ethmoid approach, respectively. The superior turbinate was resected in 27 cases (70.3%), and 16 patients (42.1%) underwent ethmoidectomy. No significant difference in the frequency of recurrence was detected between the trans-septal approach and the other approaches. None of the patients treated with simple sphenoidectomy or sphenoidectomy with partial ethmoidectomy suffered recurrence, which suggests that ethmoidectomy is not essential for treating ISSD.</p><p>Thin-sliced computed tomography revealed Onodi cells in 9 cases. Bleeding from the posterior septal branches of the sphenopalatine artery (SPA) occurred in 4 cases without Onodi cells. However, no episodes of such bleeding occurred in the patients with Onodi cells. This indicates that in cases of ISSD without Onodi cells, surgeons should be aware of bleeding from the posterior septal branches of the SPA.</p>

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