Sphenoethmoidectomy: the case for ethmoid marsupialization

Abstract

The authors report 510 sphenoethmoidectomies performed on 255 patients between 1969 and 1985. An overall polyp recurrence rate of 19.2% and less than a 1% complication rate are reported during that time. In patients followed jointly by the otolaryngologists and allergist, including 374 consecutive sphenoethmoidectomies on 187 patients who had this operation performed by the senior author, there was an overall polyp recurrence rate of 15% and a complication rate which was again less than 1%. Recent improvements in recurrence rates and diminished complication rates are attributed to better visualization and adherence to the concept of complete exenteration or marsupialization of the ethmoid labyrinth including middle turbinate resection in every case. Cooperation between the otolaryngologist and allergist is stressed, along with the realization that pulmonary and sinus diseases are frequently interrelated and may both be benefited by the performance of sphenoethmoidectomy in the patient with hyperplastic rhinosinusitis.