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Isolated sphenoid sinus disease: differential diagnosis and management

Ng, Yuk Hui; Sethi, Dharmbir S

Current Opinion in Otolaryngology & Head and Neck Surgery: February 2011 - Volume 19 - Issue 1 - p 16–20
doi: 10.1097/MOO.0b013e32834251d6
Nose and paranasal sinuses: Edited by Anshul Sama

Purpose of review To review the current literature on isolated disease of sphenoid sinus, and to describe the various approaches to the sphenoid sinus.

Recent findings Due to its posterior location and subtle presenting symptoms, sphenoid lesions, in the past, have often been missed and were reported as rare occurrences. However, with the availability of current diagnostic modalities such as endoscopy and imaging techniques such as computed tomography (CT) and magnetic resonance imaging (MRI), diseases of the sphenoid sinus are now more frequently diagnosed. Since the introduction of endoscopic techniques in the mid 1980s, various endoscopic approaches to the sphenoid sinus, depending on the extent and type of disease, have been described. These approaches were subsequently ‘extended’ to remove pituitary tumours, and certain diseases of the parasellar region and the petrous apex. More recently, further extension of these approaches has led to the development of endoscopic skull base surgery, using the sphenoid sinus as the ‘gateway’ to the anterior, middle and the posterior cranial fossa. These approaches require a clear understanding of the anatomy of the sphenoid sinus and its surrounding regions.

Summary This paper presents a review of the various diseases of the sphenoid sinus and describes the approaches to the sinus with special emphasis on the transpterygoid approach to the lateral recess of the sphenoid sinus.

Department of Otolaryngology, Singapore General Hospital, Singapore

Correspondence to Yuk Hui Ng Tel: +65 6321 4469; fax: +65 6226 2079; e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.