Different Endoscopic Approaches for Sphenoid Sinus

Different Approaches for Sphenoid Sinus

• Identification of the most effective approach for different lesion types
• Correlation between approach and complication rates

Study Overview

• Status: Not yet recruiting
• Conditions: Endoscopic Sinus Surgery; Sphenoid Sinus
• Intervention / Treatment: Procedure: endoscopic sinus surgery

Detailed Description

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.

Moreover, endoscopic sinus surgery is a safe and effective technique that allows a direct route to the sphenoid sinus.

Because of its close vicinity to important and vulnerable structures of the skull base, delay in diagnosis and treatment can be potentially lethal.

Sphenoid sinus lesions may range from mild, isolated inflammation to erosive tumors with cranial nerve deficits or cases requiring access to a pneumatized lateral recess .

Additionally, conditions such as tumors, encephaloceles, mucoceles, and skull base lesions demand extra preoperative planning and careful technique selection.

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Doaa Araby Mohamed, assistant lecturer; Phone Number: +201119015094; Email: DoaaAraby9@aun.edu.eg
• Study Contact Backup: Name: Ahmed elrahman mohamed azzam, lecturer; Phone Number: 01099978990; Email: ahmedazzam@aun.edu.eg

Study Locations

• Egypt
  • Asyut, Egypt
    • Assiut University Hospital
    • Contact: Doaa Mohamed; Phone Number: 01119015094; Email: DoaaAraby9@aun.edu.eg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child; Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients with sinonasal lesions involving sphenid sinus with or without skull base extension.

Exclusion Criteria

• Severe comorbidities contraindicating surgery
• malignant tumer extend beyond sphenoid sinus requiring open management

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: 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.

Procedure: endoscopic sinus surgery; Different approaches include: 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.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To evaluate different endoscopic surgical approaches to the sphenoid sinus	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)	6 months
To evaluate different endoscopic surgical approaches to the sphenoid sinus regarding: * Completence of lesion removal. * Complications. - Csf leakage - Optic nerve injury	complications rate (csf leakage , optic nerve injury, carotid artery injury); Recurrence; Endoscopic patency of sphenoid osteum and synechia formation	6 month

Collaborators and Investigators

• Sponsor: Assiut University
• Investigators: Study Director: mohamed modather, assistant professor, Assiut University

Publications and helpful links

General Publications

• https://scholar.google.com/?hl=ar

Helpful Links

• Castelnuovo, P., Pagella, F., Semino, L., De Bernardi, F., & Delù, G. (2005). Endoscopic treatment of the isolated sphenoid sinus lesions. European Archives of Oto-Rhino-Laryngology and Head & Neck, 262(2), 142-147.
• 3-Jang, J. Y., Kim, G. J., Kim, S. Y., Kim, M. S., Lee, D. K., Kwon, M., ... & Cho, K. J. (2025). Guidelines for the treatment of laryngeal cancer from the Korean society of head and neck surgery. Clinical and experimental otorhinolaryngology, 18(2), 89-
• -Lawson, W., & Reino, A. J. (1997). Isolated sphenoid sinus disease: an analysis of 132 cases. The Laryngoscope, 107(12), 1590-1595..

Study record dates

Study Major Dates

• Study Start (Estimated): August 1, 2026
• Primary Completion (Estimated): August 1, 2028
• Study Completion (Estimated): September 1, 2028

Study Registration Dates

• First Submitted: July 7, 2026
• First Submitted That Met QC Criteria: July 10, 2026
• First Posted (Actual): July 14, 2026

Study Record Updates

• Last Update Posted (Actual): July 14, 2026
• Last Update Submitted That Met QC Criteria: July 10, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Other Study ID Numbers: sphenoid sinus approaches

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No