Endoscopic Surgery of the Sphenoid Sinus

The sphenoid bone is the skull base’s central skeleton and the main corridor to the skull base lesions. It consists of a body, four lateral arms (2 lesser and 2 greater wings), and two inferior bony projections (pterygoid bodies). The sphenoid sinus is a paired mucosal-lined air cell within the body of the sphenoid with a variable degree of pneumatization posteriorly, laterally, and inferiorly. It is bounded by an ethmoidal air cell anteriorly with variable extended pneumatization posteriorly to form a sphenoethmoidal (Onodi) air cell. It is bordered superiorly by the pituitary gland and the planum sphenoidale, inferiorly by the choanae, posteriorly by the clivus, and laterally by the cavernous sinuses and the cavernous carotid arteries [1]. Vital structures such as the optic nerve, internal carotid artery, cavernous sinuses, maxillary nerves, and Vidian bundle may be injured during endoscopic sphenoidal surgery. So, surgeons should have excellent anatomical knowledge and experience before navigating into the sphenoid sinus and the skull base.