{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T04:53:58Z","timestamp":1767675238791,"version":"3.40.5"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T00:00:00Z","timestamp":1623024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Cerebrospinal fluid (CSF) leaks and meningoencephaloceles originating in the lateral recess of the sphenoid sinus can be challenging. The traditional transpterygoid approach through the pterygopalatine fossa (PPF) is time consuming and places important structures at risk, which can lead to significant morbidity. We report a multi\u2010institutional experience using a simplified, endoscopic modified transpterygoid approach (MTPA), which spares the PPF contents in the management of lateral sphenoid sinus meningoencephaloceles and CSF leaks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Multi\u2010Institutional, Retrospective Case Series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with lateral sphenoid recess CSF leaks and meningoencephaloceles between 2014 and 2020 who underwent the MTPA at two academic medical centers were identified. Repair techniques and outcomes were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010three patients underwent the MTPA for management. Skull base reconstruction was performed using a free mucosal graft (24\/33, 72.7%), nasoseptal flap (4\/33, 12.1%), bone grafts (3\/33, 9.1%), and abdominal fat grafts (2\/33, 6.1%). Lumbar drains and perioperative intracranial pressure measurements were routinely employed. Postoperative complications were uncommon and included three patients (9.7%) with temporary V2 anesthesia, one patient (3.2%) with prolonged V2 anesthesia, and one patient (3.2%) with subjective dry eye, all of which resolved at 9\u2009months postoperatively. There were no recurrent CSF leaks resulting in a 100% success rate. Average follow\u2010up was 13\u2009months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The MTPA reduces morbidity and greatly simplifies access to the lateral sphenoid sinus for the management of CSF leaks and meningoencephaloceles, without compromising exposure. This technique avoids the need for extensive PPF dissection and should be considered for the management of benign lesions involving the lateral sphenoid sinus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4 <jats:italic>Laryngoscope<\/jats:italic>, 131:2224\u20132230, 2021<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.29672","type":"journal-article","created":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T19:36:21Z","timestamp":1623180981000},"page":"2224-2230","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Modified Transpterygoid Approach to Sphenoid Meningoencephaloceles: A Shorter Run for a Longer Slide"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0384-9870","authenticated-orcid":false,"given":"Satyan B.","family":"Sreenath","sequence":"first","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2315-9930","authenticated-orcid":false,"given":"Dennis M.","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Cedars\u2010Sinai Medical Center  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan Y.","family":"Ting","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Indiana University  Indianapolis Indiana U.S.A."},{"name":"Department of Neurosurgery Indiana University  Indianapolis Indiana U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisa A.","family":"Illing","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Indiana University  Indianapolis Indiana U.S.A."},{"name":"Department of Neurosurgery Indiana University  Indianapolis Indiana U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9748-2784","authenticated-orcid":false,"given":"Pablo F.","family":"Recinos","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio U.S.A."},{"name":"Department of Neurological Surgery and Rosa Ella Burkhardt Brain Tumor and Neuro\u2010Oncology Center Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pranay","family":"Soni","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and Rosa Ella Burkhardt Brain Tumor and Neuro\u2010Oncology Center Cleveland Clinic  Cleveland Ohio U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varun R.","family":"Kshettry","sequence":"additional","affiliation":[{"name":"Head and Neck Institute Cleveland Clinic  Cleveland Ohio U.S.A."},{"name":"Department of Neurological Surgery and Rosa Ella Burkhardt 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