[The management of space-occupying lesion of middle skull base involving sphenoid sinus by transnasal endoscopic surgery]

Abstract

Objective: To investigate the diagnosis and therapy of space-occupying lesion of middle skull base involving sphenoid sinus.

Method: A retrospective analysis was performed. Eighteen patients with extradural space-occupying lesion of middle skull base involving sphenoid sinus underwent transnasal endoscopic surgery.

Result: One case of primary empty sella turcica was misdiagnosed as sphenoidal sinus cyst. One case of fibrous dysplasia and one case of meningioma were all misdiagnosed as mycotic sphenoiditis. Total rate of misdiagnosis was 16.7%. Among the 18 cases, 17 cases underwent complete resection of the lesion, and only 1 case underwent major resection of the lesion. The amount of blood loss during surgery ranged between 100 ml and 2,500 ml. One case had bacterial meningitis which was cured after corresponding treatment. One case was blind in both eyes. And the other case died of pulmonary embolism.

Conclusion: Transnasal endoscopic surgery is feasible and practical to treat benign space-occupying lesion of sphenoidal sinus and extradural lesion of middle skull base involving sphenoidal sinus. Definite diagnosis, accurate location and careful operation are important to complete the surgery successfully.