Approach of transnasal endoscopic treatment of isolated sphenoiditis
Objective: To assess the effectiveness of endoscopic transnasal access in the treatment of isolated sphenoiditis. Methods: For the period 2015-2017, 8 patients with isolated sphenoiditis aged from 22 to 55 years (mean age - 38.5 years) were examined. Of these, 4 patients suffered from the chronic exudative process, 1 - the proliferative form of sphenoiditis, and in 3 patients acute exudative sphenoiditis was diagnosed. The choice of method of treatment depended on the history of the disease, endoscopic and CT-examination data. Results: Three patients with acute exudative and two with chronic exudative sphenoiditis are prescribed conservative treatment. In one observation, under the general endotracheal anaesthesia, sphenoidotomy was performed transseptal for the free clearance of the sinus cavity from pathologically proliferatively altered masses. Two patients with chronic exudative sphenoiditis underwent a minimally invasive endoscopic transnasal dissection of the anterior wall of the sphenoid sinus with a catheter inserted into the sphenoidal sinus cavity through this window to evacuate the pus, wash the sinus and introduction of the medicinal substances. There were no complications in the immediate postoperative period. Conclusions: The current study shows that the use of minimally invasive transnasal endoscopic treatment with catheterization of sphenoid sinus in patients with isolated exudative sphenoiditis can be considered an optimal and relatively safe method.