Innovative instrument for natural sphenoid ostium enlargement

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Abstract

Background: Advances in the surgical treatment of chronic sphenoiditis are not possible without the development of specialized instruments for manipulation in the sphenoethmoidal recess. The creation and clinical implementation of innovative tools for sphenoidotomy remain a relevant objective in modern rhinologic surgery.

Aim: To present the outcomes of using an innovative instrument designed for the enlargement of the natural sphenoid sinus ostium.

Methods: The instrument was developed by the Departments of Otorhinolaryngology of the Russian Medical Academy of Continuous Professional Education (Kazan branch) and Kazan Federal University. The proposed device Forceps for opening and enlarging the sphenoid ostium with a pathological tissue removal function is engineered to account for the anatomy of the anterior sphenoid wall and enables minimally invasive medial partial resection of the natural ostium.

Results: In the first stage of this study, anatomical experiments were conducted on 12 sphenoid sinuses from 6 cadavers, using the forceps for opening and enlarging the sphenoid ostium. The second stage included surgical treatment of 11 patients with isolated sphenoiditis. The performed resection created favorable conditions for reparative regeneration of tissue from the intact regions of the natural ostium, thereby preventing stenosis or fibrotic obliteration.

Conclusion: Clinical use of the Forceps for opening and enlarging the sphenoid ostium with a pathological tissue removal function demonstrated an absence of complications such as stenosis or fibrotic obliteration of the sphenoid ostium.

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About the authors

Vladimir N. Krasnozhen

Russian Medical Academy of Continuous Professional Education; Kazan Federal University

Email: vn_krasnozhon@mail.ru
ORCID iD: 0000-0002-1564-7726
SPIN-code: 4020-8920

MD, Dr. Sci. (Medicine)

Russian Federation, Kazan; Kazan

Elena M. Pokrovskaya

Russian Medical Academy of Continuous Professional Education; Kazan Federal University

Author for correspondence.
Email: epokrunia@inbox.ru
ORCID iD: 0000-0001-9437-4895
SPIN-code: 5051-9591

MD, Dr. Sci. (Medicine)

Russian Federation, Kazan; Kazan

Diana R. Valeeva

Clinic “Family Health”

Email: diramilevna.dr@mail.ru
ORCID iD: 0000-0002-4835-9165

MD

Russian Federation, Kazan

Valentina V. Fedorova

Kazan Federal University; Clinic “Family Health”

Email: vella91@mail.ru
ORCID iD: 0009-0009-3546-6082

MD

Russian Federation, Kazan; Kazan

References

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Supplementary files

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2. Fig. 1. Forceps for opening and enlarging the sphenoid ostium with a pathological tissue removal function.

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3. Fig. 2. Working part of the instrument with a through-cutting design featuring a reverse punch mechanism and a rotating jaw.

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4. Fig. 3. Instrument in the closed position.

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5. Fig. 4. 0° endoscope, d = 4 mm. The distal part of the instrument is inserted into the sphenoid sinus; the movable jaw is open in preparation for through-cutting and medial ostium resection (cadaver specimen).

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6. Fig. 5. 0° endoscope, d = 4 mm. Endoscopic view of the right sphenoethmoidal recess. View of the natural sphenoid ostium following resection of the medial portion of the natural ostium (cadaver specimen).

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7. Fig. 6. 3D computed tomography (axial view) of left-sided sphenoiditis: (a) preoperative image; (b) postoperative image.

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