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Anatomical landmarks for locating the sphenoid ostium during endoscopic endonasal approach: a cadaveric study

  • Anatomic Bases of Medical, Radiological and Surgical Techniques
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Abstract

Purpose

The sphenoid ostium (SO) provides a natural portal for entering the sphenoid sinus and beyond up to the skull base. It is not always easy to locate the ostium during the endoscopic approach. The present study was designed to establish readily identifiable anatomical landmarks for locating the sphenoid ostium.

Methods

Cadaveric dissection was performed in 30 hemisections of head and neck and various measurements were taken from fixed anatomical landmarks in the nasal cavity to the sphenoid ostium. The size, shape and position of sphenoid ostium were determined in relation to the anterior wall of the sphenoid sinus and the superior turbinate.

Results

The mean distance from the supero-lateral angle of the posterior choana to the SO was found to be 21.21 ± 6.02 mm. The mean distance of the SO from the midline was 4.85 ± 2.89 mm. In all the specimens, the SO was situated within 1 cm of the midline. The mean distance between the inferior end of the SO and the postero-inferior edge of the superior turbinate was 8.03 ± 3.52 mm. The SO was present on an average distance of 55.1 ± 3.54 mm from the limen nasi. In 93.3 % of the specimens, the SO was situated between 5 and 6 cm of the inferior end of the limen nasi. The angle between the anterior nasal spine and the SO was found to be remarkably constant. In 93.3 % of the specimens, it was from 25° to 30°.

Conclusions

The sphenoid ostium could be localized medial to the superior turbinate between 1.5 and 3 cm above the supero-lateral angle of the posterior choana, within 1 cm of the midline and within 1 cm of the postero-inferior edge of the superior turbinate.

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References

  1. Abuzayed B, Tanriöver N, Ozlen F, Gazioğlu N, Ulu MO, Kafadar AM, Eraslan B, Akar Z (2009) Endoscopic endonasal transsphenoidal approach to the sellar region: results of endoscopic dissection on 30 cadavers. Turk Neurosurg 19(3):237–244

    PubMed  Google Scholar 

  2. Campero A, Emmerich J, Scolovsky M et al (2010) Microsurgical anatomy of the sphenoid ostia. J Clin Neurosci 17:1298–1300

    Article  PubMed  Google Scholar 

  3. Davis WE, Templer J, Parsons DS (1996) Anatomy of the paranasal sinuses. Otolaryngol Clin North Am 29:57–74

    PubMed  CAS  Google Scholar 

  4. Elwany S, Yacout YM, Talaat M, EI-Nahass M, Gunied A, Talaat M (1983) Surgical anatomy of the sphenoid sinus. J Laryngol Otol 97:227–241

    Article  PubMed  CAS  Google Scholar 

  5. Enatsu K, Takasaki K, Kase K et al (2008) Surgical anatomy of the sphenoid sinus on the CT using multiplanar reconstruction technique. Otolaryngol Head Neck Surg 138:182–186

    Article  PubMed  Google Scholar 

  6. Eweiss AZ, Ibrahim AA, Khalil HS (2012) The safe gate to the posterior paranasal sinuses: reassessing the role of the superior turbinate. Eur Arch Otorhinolaryngol 269:1451–1456

    Article  PubMed  Google Scholar 

  7. Hidir Y, Battal B, Durmaz A et al (2011) Optimum height from the roof of the choana for seeking the sphenoid ostium. J Craniofac Surg 22:1077–1079

    Article  PubMed  Google Scholar 

  8. Hosemann WG, Weber RK, Keerl RE et al (2000) Minimally invasive endonasal sinus surgery. Principles, techniques, results, complications, revision surgery. Thieme, New York

  9. Kim HU, Kim SS, Kang SS et al (2001) Surgical anatomy of the natural ostium of the sphenoid sinus. Laryngoscope 111:1599–1602

    Article  PubMed  CAS  Google Scholar 

  10. Lang J (1989) Clinical anatomy of the nose, nasal cavity and paranasal sinuses. Thieme Medical, New York

    Google Scholar 

  11. Levine HL (2004) Surgical approaches: endonasal endoscopic. In: Clemente MP, Levine HL (eds) Sinus surgery. Endoscopic and microscopic approaches. Thieme, New York, pp 154–156

    Google Scholar 

  12. Locatelli M, Caroli M, Pluderi M et al (2011) Endoscopic transsphenoidal optic nerve decompression: an anatomical study. Surg Radiol Anat 33(3):257–262

    Article  PubMed  Google Scholar 

  13. Millar DA, Orlandi RR (2006) The sphenoid sinus natural ostium is consistently medial to the superior turbinate. Am J Rhinol 20:180–181

    PubMed  Google Scholar 

  14. Orhan M, Govsa F, Saylam C (2010) A quite rare condition: absence of sphenoidal sinuses. Surg Radiol Anat 32(6):551–553

    Article  PubMed  Google Scholar 

  15. Sethi DS, Leong JL (2006) Endoscopic pituitary surgery. Otolaryngol Clin North Am 39:563–583

    Article  PubMed  Google Scholar 

  16. Turgut S, Gumusalan Y, Arifoglu Y, Sinav A (1996) Endoscopic anatomic distances on the lateral nasal wall. J Otolaryngol 25:371–374

    PubMed  CAS  Google Scholar 

  17. Wigand ME (1990) Endoscopic surgery of the paranasal sinuses and anterior skull base. Thieme Medical, New York

    Google Scholar 

  18. Yanagisawa E, Yanagisawa K, Christmas DA (1998) Endoscopic localization of the sphenoid sinus ostium. Ear Nose Throat J 77:88–89

    PubMed  CAS  Google Scholar 

  19. Zhang Y, Wang Z, Liu Y et al (2008) Endoscopic transsphenoidal treatment of pituitary adenomas. Neurol Res 30:581–586

    Article  PubMed  CAS  Google Scholar 

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The authors declare that they have no conflict of interest.

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Correspondence to Tulika Gupta.

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Gupta, T., Aggarwal, A. & Sahni, D. Anatomical landmarks for locating the sphenoid ostium during endoscopic endonasal approach: a cadaveric study. Surg Radiol Anat 35, 137–142 (2013). https://doi.org/10.1007/s00276-012-1018-8

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  • DOI: https://doi.org/10.1007/s00276-012-1018-8

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