Sphenoidotomy: Transethmoid Approach

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