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Sphenoid sinus surgery is an important component of the management paradigm of inflammatory sinus disease as well as integral to the approaches to the sellar and parasellar regions for skull base lesions. Given this dual perspective, the surgeon must carefully appraise the surgical goals in the setting of the patient’s anatomy and pathology. Successful surgery requires these considerations, in addition to knowledge of the variable anatomy and anatomic relationships in the region. While complications can occur in any surgical procedure, complications in this delicate region can be devastating and are best managed with prevention. If encountered, rapid identification and initiation of further diagnostic and/or therapeutic measures is critical. This chapter presents the various surgical techniques, considerations, and anatomic relationships that are necessary for the endoscopic sinus and skull base surgeon to master surgery within this critical region. Multiple different approaches for successfully finding the sphenoid ostium are also discussed. Understanding these key anatomic features allows surgical management of an array of extracranial and intracranial pathology. Careful preoperative clinical and radiographic examinations significantly aid the surgical approach and allow the surgeon to be proactive rather than reactive when addressing the area.

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Correspondence to Brent A. Senior MD, FACS, FARS .

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McClurg, S.W., Thorp, B.D., Senior, B.A. (2015). Surgery for Sphenoid Sinus Disease. In: Batra, P., Han, J. (eds) Practical Medical and Surgical Management of Chronic Rhinosinusitis. Springer, Cham.

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