A Novel International Endoscopic Sphenoid Surgery Classification (IESSC): A Delphi Consensus

Albaharna H 1 , Alrasheed A 2 , AlQahtani A 3 , Psaltis AJ 4 , Javer A 5 , Meco C 6 Show all authors , Georgalas C 7 , Wang EW 8 , Alobid I 9 , Omura K 10 , Macias-Valle LF 11 , Tewfik M 12 , Prepageran N 13 , Battaglia P 14 , Castelnuovo P 14 , Carrau R 15 , Douglas R 16 , Harvey R 17 , Casiano RR 18 , Ahmed S 19 , Alsaleh S 2

Affiliations 

  • 1 Department of Otolaryngology- Head & Neck Surgery, Qatif Central Hospital, Qatif, Saudi Arabia
  • 2 Department of Otolaryngology - Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
  • 3 Department of Otorhinolaryngology - Head and Neck Surgery, King Fahad Medical City, Riyadh, Saudi Arabia
  • 4 Department of Surgery-Otolaryngology Head and Neck Surgery, University of Adelaide and the Basil Hetzel Institute for Translational Health Research, Central Adelaide Local Health Network, Adelaide, Australia
  • 5 St. Paul's Sinus Centre, University of British Columbia, Vancouver, Canada
  • 6 Department of Otorhinolaryngology - Head and Neck Surgery, Ankara University Medical School, Ankara, Turkey
  • 7 University of Nicosia, Nicosia, Cyprus
  • 8 Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
  • 9 Skull Base Unit, ENT Department, Hospital Clinic. IDIBAPS, CIBERES, Universitat de Barcelona, Barcelona, Spain
  • 10 Department of Otorhinolaryngology/Head and Neck Surgery, The Jikei University School of Medicine, Tokyo, Japan
  • 11 Rhinology Unit. Department of Otolaryngology Head and Neck Surgery, LaSalle University. Hospital Español de México, México City, México
  • 12 Department of Otolaryngology - Head & Neck Surgery, McGill University, Montreal, Canada
  • 13 Department of Otorhinolaryngology, Faculty of Medicine, Universiti Malaya, Jalan Universiti, Wilayah Persekutuan, Kuala Lumpur, Malaysia
  • 14 Department of Otorhinolaryngology, Insubria University, Como, Italy
  • 15 Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
  • 16 Department of Surgery, The University of Auckland, Auckland, New Zealand
  • 17 Department of Otolaryngology, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
  • 18 Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, USA
  • 19 Department of Otolaryngology, Queen Elizabeth Hospital University Hospitals Birmingham NHS Foundation Trust Birmingham, Birmingham, UK
Int Forum Allergy Rhinol, 2025 Mar 24.
PMID: 40126454 DOI: 10.1002/alr.23572

Abstract

BACKGROUND: Advancements in endoscopic sinus and skull base surgery created a need for standardized terminology to describe sphenoid sinus surgery. Although classification systems exist for other sinuses, one for endoscopic sphenoid sinus surgery is lacking. Developing such a system would standardize procedure descriptions and promote a common language among surgeons. This study aimed to develop a new classification system for endoscopic sphenoid surgery.

METHODS: Consensus on a novel endoscopic sphenoid surgery classification system by running the Delphi procedure with 16 rhinology experts from around the world.

RESULTS: Four Delphi rounds were required to reach a consensus on all stages of the classification. The average percentage of agreement on the stages of classification progressively increased from 70.83% in the first round to 87.68% in the last round. The rejection rates continuously decreased from 8.81% in the first round to 4.44% in the last round. The classification system was developed as follows: stage 1, presphenoid surgery; stage 2A, partial sphenoidotomy; stage 2B, complete sphenoidotomy; stage 2C, transpterygoid sphenoidotomy; stage 3A, Rostral sphenoidectomy; and stage 3B, extended sphenoid drill-out.

CONCLUSIONS: This novel endoscopic sphenoid surgery classification system facilitates the description of different sphenoid sinus procedures, providing surgeons with better opportunities for discussion and communication.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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