Endoscopic Endonasal Partial Middle Turbinectomy Approach: Adaptability of the Procedure in a Cadaveric Study and in Surgery for Different Sphenoid Sinus and Skull Base Lesions

Omar A. El-Banhawy; Abd El-Hafiz Shehab El-Dien; Ahmed Said Zolfakar; Ahmed N. Halaka; Heshmat Ayad

doi:10.1055/s-2005-922014

Skull Base, Table of Contents

Skull Base 2006; 16(1): 001-013
DOI: 10.1055/s-2005-922014

ORIGINAL ARTICLE

Endoscopic Endonasal Partial Middle Turbinectomy Approach: Adaptability of the Procedure in a Cadaveric Study and in Surgery for Different Sphenoid Sinus and Skull Base Lesions

Omar A. El-Banhawy¹ , Abd El-Hafiz Shehab El-Dien³ , Ahmed Said Zolfakar² , Ahmed N. Halaka⁴ , Heshmat Ayad⁴

¹Department of ENT, Faculty of Medicine, El Menoufyia University, El-Mansoura, El Dakahlia, Egypt
²Department of Anatomy, Faculty of Medicine, El Menoufyia University, El-Mansoura, El Dakahlia, Egypt
³Department of Neurosurgery, El-Mansoura International Hospital, El-Mansoura, El Dakahlia, Egypt
⁴Department of Neurosurgery, El-Hikmah Hospital, El-Mansoura, El Dakahlia, Egypt

Abstract

ABSTRACT

Objective: To demonstrate the flexibility, adaptability, and efficacy of endoscopic endonasal removal of the inferior half of the middle turbinate in a cadaveric study and in surgery for the treatment of different sphenoid sinus and skull base lesions. Methods: Anatomic Cadaveric Study: Five adult cadaveric heads were studied. Six nostrils of 3 cadavers were studied endoscopically after the lower half of the middle turbinate was removed. Two adult cadaveric heads underwent bilateral paraseptal sagittal sectioning and were studied after the lower half of the middle turbinate was removed. Sixty-five patients with different sphenoid sinus and skull base-related lesions were treated through this surgical approach. Results: This approach increased surgical exposure, decreased tubular vision, and offered wider anatomic panoramic orientation with 0-degree and angled endoscopes. In the surgical group, there were no major intra- or postoperative complications. The approach improved exposure, accessibility to the lesion, and permitted good hemostasis, tumor resection, and repair of the skull base defect. Conclusion: The current approach provides a wide surgical field without increasing morbidity. It avoids unnecessary trauma to the other nostril as occurs in a binostril approach. The harvested piece of turbinate tissue is an excellent source of donor material for successful reconstruction of the sellar floor without inducing side effects or complications.

KEYWORDS

Middle turbinate - endoscopic - endonasal

Full Text

References

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Omar A El-BanhawyM.D.

7th floor, Borg El-Ula, El-Shoula Square, El-Mansoura, El Dakahlia, Egypt

Email: oelbanhawy@hotmail.com