Abstract: To explore the method of sphenoid sinus and trans-sphenoid surgery by a direct hemi-nasal approach. MethodsWith nasal endoscopy and microscopy, the middle conchas were moved outside by Hardy′s stretcher, the nasal cavities were broadened, the frontal walls of sphenoid sinus were opened, and the lesions were removed. Results12 cases of simple sphenoid sinusitis had the aperture well opened and then symptoms disappeared. 9 cases had the sphenoid sinus cyst and meningoma removed. 1 case of sphenoid sinus osteoma recovered well. 1 case of traumatic ablepsia received decompression of the optic canal but no recovery was found after the operation. In 33 cases of pituitary adenoma, 18 tumor were totally removed, 12 were sub-totally removed, and 3 were fully removed, and they were all further treated by post-operative X-knife. During a postoperative follow-up of half to 3.5 years, there were no recurrences in cases of sphenoid sinusitis, sphenoid sinus cyst, meningoma or phenoid sinus osteoma. Pituitary adenoma recurred in 3 cases. All cases had no intracranial and nasal complications. ConclusionSphenoid sinus and trans-sphenoid surgeries by a direct hemi-nasal approach with nasal endoscopy and microscopy have advantages of minimal invasion, less time and bleeding, few complications and good effect.

Key words: Minimal invasive surgery, Treatment outcome, Sphenoid sinus