Diagnosis and surgical treatment of six cases with isolated sphenoid sinus neoplasm

Purpose:To study the diagnosis and surgical treatment of isolated spheniod sinus neoplasms. Methods:6 cases with isolated sphenoid sinus neoplasm were analyzed. All patientes had headache, five had visual-neural symptoms. In all cases, the isolated space-occupying lesions in sphenoid sinus were verified by CT scan, and biopsies were made under nasal endoscopy before operation. Two cases were benign, including 1 inverting papilloma, 1 papillary adenoma. Four cases were malignant, including 2 sphenoidal sinus low differentiated carcinoma, 1 adenoidocystic carcinoma, 1 inverting pallilloma with malignant change. 1 case with papillary adenoma underwent endoscopic surgery, and 5 cases underwent surgery by external approach. Results:Among the 4 malignant cases, 3 patient did not recurren after surgery and radiotherapy for 18 to 28 months. 1 patient was lost to follow-up. Among the 2 benign cases, 1 case with papillary adenoma was cured after 40 months, the symptoms of the other was improved after 15 months. Conclusions:Nasal endoscopic and imaging study is very important for the diagnosis and surgery of lesions in isolated sphenoid sinus neoplasm. The benign lesion is operated by nasal endoscope, and malignant lesion is treated by operation and radiotherapy. External ethmoidectomy is a method of choice for malignant lesions.