PEDIATRIC SPHENOIDOTOMY

The posterior ethmoid air cells and the sphenoid sinuses have a comple x anatomy that is surrounded by vital structures. To more easily prote ct these structures, three approaches are presented that make pediatri c sphenoidotomy a safer procedure. The approaches include measuring th e distance from the anterior nasal spine to the anterior and surgical posterior faces of the sphenoid sinus intraoperatively and comparing t hese to the patient's height and age, the use of the ''ridge'' to ensu re a safe Entry into the sphenoid, and, in patients where isolated sph enoid disease is present, the use of a powered instrument to enlarge t he sphenoid ostium. The availability of measurements relating the heig ht of the patient to the location of the sphenoid sinus, the use of th e ''ridge,'' and the use of powered instrumentation, should help the s urgeon enter the sphenoid with greater confidence and achieve a more e ffective result.