Repair of CSF Leaks in the Lateral Recess of the Sphenoid Sinus Transsphenoid vs . Transpterygoid Approach

Cerebrospinal fluid (CSF) leaks involving the lateral extension of the sphenoid sinus create unique challenges for the endoscopic approach. Such defects are typically inaccessible through a typical transethmoid or transsphenoid corridor. Recently, an endoscopic transpterygoid approach to the lateral sphenoid recess has been adopted and reported by several groups. However, this technique requires extended surgical time and can put the sphenopalatine ganglion and maxillary division of the trigeminal nerve at risk. In the current study we detail our experience with an extended transnasal transsphenoidal approach to lateral sphenoid sinus CSF leaks and meningoencephaloceles.