The superior turbinectomy approach to isolated sphenoid sinus disease and to the sella turcica

Sphenoidotomy or sphenoidectomy are most commonly performed as part of a mo re extensive pansinus procedure. However, rhinologists may find themselves occasionally in a need to surgically tl-eat an isolated sphenoid sinus dise ase. With the introduction of endoscopic sinus techniques and instrumentati on, intranasal sphenoidotomy, has become increasingly popular. The most com mon approach used is the intranasal, transethmoid sphenoidectomy, Alternati vely, many surgeons perform middle turbinectomy to approach the sphenoid si nus transnasally. We describe our direct transnasal, nontransethmoid nontra nsseptal approach to the sphenoid sinus. Superior turbinectomy is performed to enhance the exposure of the anterior sphenoid wall. Seventy patients un derwent sphenoid sinus exploration for isolation sphenoid sinus disease or for pituitary lesions. Surgical goals were achieved in all patients and the re were no complications related to the technique. The superior turbinectom y approach to isolated sphenoid sinus disease provides excellent exposure a nd avoids the sequelae of total ethmoidectomy ol middle turbinectomy.