Ng Yuk Hui, Sethi Dharmbir S
Department of Otolaryngology, Singapore General Hospital, Singapore.
Curr Opin Otolaryngol Head Neck Surg. 2011 Feb;19(1):16-20. doi: 10.1097/MOO.0b013e32834251d6.
To review the current literature on isolated disease of sphenoid sinus, and to describe the various approaches to the sphenoid sinus.
Due to its posterior location and subtle presenting symptoms, sphenoid lesions, in the past, have often been missed and were reported as rare occurrences. However, with the availability of current diagnostic modalities such as endoscopy and imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI), diseases of the sphenoid sinus are now more frequently diagnosed. Since the introduction of endoscopic techniques in the mid 1980s, various endoscopic approaches to the sphenoid sinus, depending on the extent and type of disease, have been described. These approaches were subsequently 'extended' to remove pituitary tumours, and certain diseases of the parasellar region and the petrous apex. More recently, further extension of these approaches has led to the development of endoscopic skull base surgery, using the sphenoid sinus as the 'gateway' to the anterior, middle and the posterior cranial fossa. These approaches require a clear understanding of the anatomy of the sphenoid sinus and its surrounding regions.
This paper presents a review of the various diseases of the sphenoid sinus and describes the approaches to the sinus with special emphasis on the transpterygoid approach to the lateral recess of the sphenoid sinus.
回顾目前关于蝶窦孤立性疾病的文献，并描述蝶窦的各种手术入路。
由于蝶窦位置较深且症状隐匿，过去蝶窦病变常被漏诊，报道较少见。然而，随着当前诊断手段如内镜以及成像技术如计算机断层扫描（CT）和磁共振成像（MRI）的应用，蝶窦疾病现在更常被诊断出来。自20世纪80年代中期引入内镜技术以来，根据疾病的范围和类型，已经描述了多种蝶窦的内镜手术入路。随后这些入路被“扩展”用于切除垂体肿瘤以及鞍旁区域和岩尖的某些疾病。最近，这些入路的进一步扩展导致了内镜颅底手术的发展，以蝶窦作为进入前颅窝、中颅窝和后颅窝的“通道”。这些入路需要对蝶窦及其周围区域的解剖结构有清晰的了解。
本文综述了蝶窦的各种疾病，并描述了蝶窦的手术入路，特别强调了经翼突入路至蝶窦外侧隐窝。
