Erylmaz Adil, Dursun Engin, Saylam Güleser, Göçer Celil, Dağli Muharrem, Korkmaz Hakan
Department of Otolaryngology, Ankara Numune Hospital, Ankara, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2007;17(2):90-5.
We evaluated endoscopic transnasal sphenoidotomy (ETNS) with or without ethmoidectomy in patients with inflammatory sphenoid sinus disease (ISSD).
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.
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).
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.
我们评估了在患有炎性蝶窦疾病（ISSD）的患者中，行或不行筛窦切除术的鼻内镜经鼻蝶窦切开术（ETNS）。
对42例患者（17例男性，25例女性；平均年龄41岁；范围17至67岁）进行了回顾性研究，这些患者因ISSD接受了ETNS，其中37例行筛窦切除术，5例未行筛窦切除术。根据我们基于计算机断层扫描结果的分期系统对疾病进行分期。
鼻后引流是最常见的症状（n = 37，88.1%）。25例患者（59.5%）的慢性鼻窦炎伴有鼻息肉。5例患者（11.9%）患有孤立性蝶窦疾病，16例患者（38.1%）患有单侧疾病。5例患者（11.9%）为1期，15例患者（35.7%）为2期，22例患者（52.4%）为3期疾病。手术涉及68侧。37例患者中的63侧使用了筛窦切除术，其中8例需要辅助手术。8例患者（19%）出现至少一种并发症，包括严重围手术期出血（n = 2）、术后早期出血（n = 2）、眶纸板轻微损伤（n = 4）和粘连（n = 5）。
对于孤立性ISSD患者，不进行筛窦切除术的ETNS直接进入蝶窦是一种有利的技术，而对于其他鼻窦并发疾病的患者，ETNS联合筛窦切除术是必要的。
