CIRUGIA ENDOSCOPICA DE SENOS PARANASALES PDF

Functional endoscopic sinonasal surgery in children. Pontificia Universidad Javeriana. Hospital Universitario San Ignacio. Indications for surgery, patient selection, techniques, extent of the procedures, instrumentation and adjuvant treatments have evolved since the introduction of endoscopic techniques back in the late eighties.

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Universidad de Buenos Aires. En el piso del seno cavernoso puede hacer prominencia el nervio maxilar. Palabras clave: senos esfenoidal, endoscopia, endonasal, senos paranasales ABSTRACT OBJECTIVE: the object of this presentation is to describe the endoscopic anatomy of the sphenoid sinus and its approaches, providing the surgeon with a step to step guide for dissection of then region in lab or everyday surgical practice.

The chosen approaches were the direct endonasal and transnasal transeptal approach. It is located in the middle and inferoposterior part of the sphenoid bone. It shows a variable size and it is surrounded by anatomic structures such as the carotid artery and the optic nerves, which can be damaged during surgical approach.

The optic nerves can protrude inside the sphenoid sinus. In some cases, the horizontal portion of the intracavernous carotid artery protrudes inside of it too.

Other anatomic structures are related to the sinus: meninges, the pituitary gland, the optic chiasm and the cavernous sinuses. The floor of the cavernous sinus may show the prominence of the maxillary nerve. In using an endoscope, interpreting and knowing exactly the anatomic relations in three dimensions, is mandatory for a successful approach to the sphenoid sinus.

The sphenoid sinus congregates the interest of multiple specialties, for being a point in common to many approaches of paranasal sinuses, decompressive surgeries of optic nerve, of medial wall of cavernous sinus and sellar region.

Endoscopic approach to sphenoid sinus allows the use of a natural orifice and highly respects anatomic structures.

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