J Neurol Surg B
DOI: 10.1055/s-0039-1692639
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Endonasal Transpterygoid Approach to Sphenoid Sinus Lateral Recess Defects

Gülpembe Bozkurt
1  Department of Biotechnology and Life Sciences, Division of Otorhinolaryngology, University of Insubria, Varese, Italy
,
Mario Turri-Zanoni
1  Department of Biotechnology and Life Sciences, Division of Otorhinolaryngology, University of Insubria, Varese, Italy
2  Department of Biotechnology and Life Sciences, Head and Neck Surgery and Forensic Dissection Research Center (HNS & FDRC), University of Insubria, Varese, Italy
,
Elisa Coden
1  Department of Biotechnology and Life Sciences, Division of Otorhinolaryngology, University of Insubria, Varese, Italy
,
Federico Russo
1  Department of Biotechnology and Life Sciences, Division of Otorhinolaryngology, University of Insubria, Varese, Italy
,
Hassan Ahmed Elhassan
3  Department of Otorhinolaryngology, Lewisham University Hospital, London, United Kingdom
,
Stefania Gallo
1  Department of Biotechnology and Life Sciences, Division of Otorhinolaryngology, University of Insubria, Varese, Italy
,
Jacopo Zocchi
1  Department of Biotechnology and Life Sciences, Division of Otorhinolaryngology, University of Insubria, Varese, Italy
,
Maurizio Bignami
1  Department of Biotechnology and Life Sciences, Division of Otorhinolaryngology, University of Insubria, Varese, Italy
2  Department of Biotechnology and Life Sciences, Head and Neck Surgery and Forensic Dissection Research Center (HNS & FDRC), University of Insubria, Varese, Italy
,
Davide Locatelli
4  Department of Biotechnology and Life Sciences, Division of Neurosurgery, University of Insubria, Varese, Italy
,
Paolo Castelnuovo
1  Department of Biotechnology and Life Sciences, Division of Otorhinolaryngology, University of Insubria, Varese, Italy
2  Department of Biotechnology and Life Sciences, Head and Neck Surgery and Forensic Dissection Research Center (HNS & FDRC), University of Insubria, Varese, Italy
› Author Affiliations
Further Information

Publication History

19 January 2019

08 May 2019

Publication Date:
21 June 2019 (online)

Abstract

Background Lesions affecting sphenoid sinus lateral recess (SSLR) are difficult to visualize and manipulate through the transnasal routes, especially when the sinus is highly pneumatized. External approaches to this area involve extensive surgery and are associated with significant morbidity. The aims of this study are to present our experience with the endoscopic transpterygoid approach as a method for approaching lesions of the SSLR and to evaluate the outcomes of this procedure.

Methods Clinical charts of patients who had lesions in the SSLR and who were treated at our institution from September 1998 to June 2018 were retrospectively reviewed. All these patients were managed by the endoscopic endonasal transpterygoid approach.

Results Thirty-nine patients were identified. No cerebrospinal fluid leak recurrences were observed during follow-up (range: 1–19.7 years; median: 2.3 years). Hypoesthesia (temporary, 1; persistent, 4) in the region innervated by the maxillary branch of the trigeminal nerve was detected in five (12.8%) patients, while symptoms due to the Vidian nerve damage (dry eye, 3; dry nasal mucosa, 1) were present in four (10%) patients.

Conclusions Although the endoscopic endonasal transpterygoid approach is an excellent corridor for dealing with lesions of the SSLR, limited rate of neurologic and lacrimal complications was observed. Potential morbidity of the intervention should be discussed during preoperative counselling.

Author contributions

Concept - G.B., M.T.Z., P.C.; Design - G.B., M.T.Z., P.C.; Supervision - G.B., M.T.Z., H.A.E., P.C., D.L.; Resource - E.C., F.R., S.G.; Materials - E.C., F.R., S.G., J.Z., D.L.; Data Collection &/or Processing - E.C., F.R., S.G., J.Z.; Analysis &/or Interpretation - G.B., M.T.Z., H.A.E., D.L., M.B., P.C.; Literature Search - G.B., M.T.Z., M.B., J.Z., P.C.; Writing - G.B., M.T.Z., H.A.E., P.C.; Critical Reviews - G.B., M.T.Z., M.B., P.C.


All authors have read and approved the final version of the article.


Financial disclosures

GB gratefully acknowledges support from the Turkish ENT Society for support of the Research Fellowship. The authors have no other funding, financial relationships, or conflicts of interest to disclose related to this article.