Abstract:
BACKGROUND:Chronic sphenoid rhinosinusitis (CSR) refractory to both medical management and 1 or more sphenoidotomies is a difficult entity to treat. In contrast to the surgical hierarchy that exists for the frontal sinus, there is no systematic approach for addressing persistent disease in the sphenoid. Sphenoid marsupialization has been advocated as a method of addressing recurrent sphenoid sinusitis. OBJECTIVE:We present a new technique called the sphenoid drill-out, which we place between traditional sphenoidotomy and sphenoid marsupialization in the surgical hierarchy for management of CSR. METHODS:We performed a retrospective review on all patients undergoing sphenoidotomy between 2005 and 2009. We studied demographics, procedure type, diagnoses, comorbidities, efficacy, revision rate, and endoscopic outcomes using Lund-Kennedy scores. RESULTS:A total of 10 patients underwent sphenoid drill-out for CSR. Average follow up was 17 months. Patients had an average of 5 prior sinus surgeries with 2.6 prior sphenoidotomies. One patient required a revision drill-out procedure. The mean preoperative and postoperative Lund-Kennedy scores were 6.67 and 1.78, which was a statistically significant difference. CONCLUSION:The sphenoid drill-out procedure is safe and effective for the management of recalcitrant CSR. It should be considered as an intermediate procedure between sphenoidotomy and sphenoid marsupialization.
journal_name
Int Forum Allergy Rhinoljournal_title
International forum of allergy & rhinologyauthors
Leight WD,Leopold DAdoi
10.1002/alr.20006subject
Has Abstractpub_date
2011-01-01 00:00:00pages
64-9issue
1eissn
2042-6976issn
2042-6984journal_volume
1pub_type
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