Endoscopic sphenoid sinus anatomy in View of Transsphenoidal Surgery: Standardized Way-point Cadaver Dissection

Objectives: In the view of continuous evolution in surgical techniques and instrumentation, cadaveric dissection is still the golden key for improving surgical skills and familiarity required for surgery in such critical regions with complicated anatomical details. We present an anatomical cadaveric dissection study to describe endoscopic anatomy of the sphenoid sinus using a waypoint stepwise dissection procedure. Patients and Methods: Cadaveric dissection was conducted progressively in twenty fresh cadavers simulating endoscopic endonasal transsphenoidal approach. Our standardized waypoint procedure was followed in all specimens determining its role as a base for surgical training in such region. Anatomical variations including; level of the sphenoid sinus ostium, sphenoid peumatization, inter-sphenoid septation and intra-sphenoid bony landmarks and measurements were evaluated. Results: The standardized waypoint cadaver dissection procedure in sphenoid sinus region provided an accurate surgical orientation and relationship between anatomical landmarks founding an ideal conception for the safe and efficient surgery. Our measurements showed significant variations related to sphenoid sinus ostium, peumatization and intra-sphenoid bony landmarks. Conclusion: Current study emphasizes the role of specialized waypoint training on cadavers for more detailed knowledge of the anatomy of challenging regions providing surgeon with a convenient surgical experience and familiarity. Although several anatomic variations were recorded in our series, it is considered as a good surgical training expedient for the alterations of anatomical structure in live surgery.