A long time follow-up of the expanding bilateral sphenoid sinus plasty application in the treatment of refractory sphenoid sinusitis

Abstract

Background The expanding bilateral sphenoid sinus plasty is an essential technique in the treatment of refractory sphenoid sinusitis. The aim of the present study was to explore the application of expanding bilateral sphenoid sinus plasty in the treatment of refractory sphenoid sinusitis. Methods Retrospective medical record review in a tertiary-care university hospital of 15 patients treated with the expanding bilateral sphenoid sinus plasty between December 2012 and December 2020. A follow-up of the surgical effect and complications were conducted. Primary outcomes evaluated were overall and disease-free survival. The end points assessed were presence of positive surgical margins, development of local, and regional recurrences. Results The patients were followed up for 12–73 months, with an average follow-up time of 28.5 ± 9.6 months. 15 cases of refractory sphenoid sinusitis were cured with well opened sphenoid sinus orifice and clean cavity. Of all the 15 cases, the symptoms were relieved after operation except preoperative hyposmia in 2 and impaired vision in one with no obvious improvement. No complications such as nasal bleeding, olfactory hypofunction and perforation of nasal septum occurred. Follow up revealed a better mucosal epithelization in all the patients within an average time of 8.6 weeks. Endoscopic sinus reexamination showed that the sphenoid sinus orifice was well opened, and no case of sphenoid sinus orifice closure was observed. Conclusion This study is a case series of a long time follow-up of the expanding bilateral sphenoid sinus plasty application in the treatment of refractory sphenoid sinusitis. With the advantages of easily intraoperative positioning, clearly exposed surgical field, full opening of sinus cavity, high surgical safety, short epithelialization time and intuitionistic postoperative follow-up, the expanding bilateral sphenoid sinus plasty is an improved way of treating refractory sphenoid sinusitis. Implications: This technique is worth being explored by surgeons for better surgical outcome.