TRANSANTRO-ETHMOSPHENOIDAL OPERATION

Abstract

Surgical observations were carried on 555 cases who had had the operation of the paranasal sinus via maxillary sinus and also had the sphenoid sinus opened.As for the locations of sphenoid sinus when there is an eminence on the basal surface of the ethmoidal sinus, the sphenoid sinus is located just under the eminence; and when there is an eminence adjacent to the posterior margin of the middle nasal concha, it is located on the medial side of the eminence.The shape of the sinus can be classified into six groups. There are some, though a few in number, who present only a trace of the sinus and also some whose sinus is lacking entirely. As for the feature of the basal surface of the ethmoidal sinus adjacent to sphenoid sinus during the-operation, about half the number observed presents the eminence on the surface, followed by those-showing a recess on the surface, and those showing a plane surface are least. When the sphenoid sinus is visible through the basal surface of the ethmoid sinus in bluish color, the sphenoid sinus is located at the medio-inferior side of the basal surface.Looking at the inner surface of sphenoid sinus, its wall presents a white and smooth aspect. When a suction tube can be easily inserted into a cavity through superior nasal meatus after pressing the middle nasal concha useing a long bladed speculum, the cavity can generally be consi-dered as the sphenoid sinus.As for the complications of the sphenoid operation 4 cases of injury to the dura mater, 3 cases of orbital disturbances, and 9 cases of hemorrhage from the sphenopalatine artery were observed.As for the pathological changes in the mucous membrane of sphenoid sinus, x-ray photograph taken, preoperatively utilizing Proetz displacement method used to give us a reliable suggestion on it. If the sinus is filled with 20% moljodol solution by Proetz method, it may be considered the pathological changes in the mucous membrane are slight.