A novel international endoscopic sphenoid surgery classification (iessc): a delphi consensus

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. Consensus on a novel endoscopic sphenoid surgery classification system by running the Delphi procedure with 16 rhinology experts from around the world. 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. This novel endoscopic sphenoid surgery classification system facilitates the description of different sphenoid sinus procedures, providing surgeons with better opportunities for discussion and communication.

Citation

Albaharna H, Alrasheed A, AlQahtani A, Psaltis AJ, Javer A, Meco C, Georgalas C, Wang EW, Alobid I, Omura K, Macias-Valle LF, Tewfik M, Prepageran N, Battaglia P, Castelnuovo P, Carrau R, Douglas R, Harvey R, Casiano RR, Ahmed S, Alsaleh S. A Novel International Endoscopic Sphenoid Surgery Classification (IESSC): A Delphi Consensus. Int Forum Allergy Rhinol. 2025 Aug;15(8):828-836. doi: 10.1002/alr.23572. Epub 2025 Mar 24.

Type

Journal Article