Sphenoidotomy: Transethmoid Approach

Survey

Indications:

  • Removal of disease from ethmoid and sphenoid sinuses

Highlights:

  • Take down uncinate process and ethmoid bulla, enter through basal lamella, and open posterior ethmoid cells
  • Identify superior meatus and superior turbinate
  • Enter sphenoid os between superior turbinate and septum

Keep in Mind/Things to Remember:

  • Top of maxillary sinus and natural sphenoid os are usually in the same horizontal plane
  • Open sphenoid os in inferior and medial direction
  • Optic canal (above) and carotid canal (below) can be visualized in the lateral wall of the sphenoid sinus