Different Approaches for Sphenoid Sinus
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- To evaluate different endoscopic surgical approaches to the sphenoid sinus
研究概览
简要总结
- Identification of the most effective approach for different lesion types
- Correlation between approach and complication rates
详细描述
The sphenoid sinus is one of the most anatomically complex and surgically challenging paranasal sinuses due to its deep location ,wide anatomical variation and proximity to critical neurovascular structures.
Important structures are adjacent to the sphenoid sinus include the dura, pituitary, optic nerve, cavernous sinus, pterygoid canal and nerve, internal carotid artery, and cranial nerves III, IV, VI, V1, V2, which are vulnerable to injury with sphenoid disease.
Wide anatomical variation such as Degree of Pneumatization , Septation Patterns , Sinus Size and Shape, Ostium Location ,Onodi Cells, Prominence or dehiscence of nearby structures.
Therefore, surgeons must carefully select the extent of dissection to create a sphenoid opening that matches the patient's pathology while avoiding the risks associated with overly extensive openings and drilling, which may prolong healing and increase the likelihood of scarring and stenosis.
Diagnostic nasal endoscopy procedures and imaging techniques are of great value for an early and precise diagnosis.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients with sinonasal lesions involving sphenid sinus with or without skull base extension.
排除标准
- •Severe comorbidities contraindicating surgery
- •malignant tumer extend beyond sphenoid sinus requiring open management
研究组 & 干预措施
endoscopic approaches for sphenoid sinus
type I, sphenoid ostial dilation. type IIa, transnasal sphenoidotomy (sphenoidotomy without ethmoidectomy). type IIb, transethmoidal sphenoidotomy (sphenoidotomy with ethmoidectomy). type III, bilateral, common cavity sphenoidotomy, or "sphenoid drill-out;" type IV, transpterygoid approach, to expose the lateral sphenoid sinus recess. type V, sphenoid nasalization, completely removing the sphenoid sinus floor.
干预措施: endoscopic sinus surgery (Procedure)
结局指标
主要结局
To evaluate different endoscopic surgical approaches to the sphenoid sinus
时间窗: 6 months
* Complete lesion removal measured by post operative imaging ct * Complications examples Csf leakage Optic nerve injury (measured by visual acuity) * Carotid artery injury(bleeding) * Infection(meningitis csf examination if suspected)
To evaluate different endoscopic surgical approaches to the sphenoid sinus regarding: * Completence of lesion removal. * Complications. - Csf leakage - Optic nerve injury
时间窗: 6 month
complications rate (csf leakage , optic nerve injury, carotid artery injury) * Recurrence * Endoscopic patency of sphenoid osteum and synechia formation
次要结局
未报告次要终点
研究者
Doaa Araby Mohamed
assistant lecturer
Assiut University