Supreme Nasal Turbinate as an Additional Surgical Landmark in Endoscopic Sinus and Skull Base Surgeries

During endoscopic sinus and skull base surgeries, surgical landmarks are routinely used to guide surgeons navigating in the narrow corridor of the sinonasal region. Risk of complications is higher in difficult cases when there is excessive bleeding or alteration of the normal anatomical landmarks by tumour. An additional landmark is advantageous to prevent complications and serves as a guide. We present a case of supreme turbinate found incidentally during an endoscopic transsphenoidal surgery. Not much is known about the role of supreme turbinate. When it is present, the sphenoid ostium is located medial to its posteroinferior attachment, and behind its vertical part. Hence, the identification of this structure serves as an additional landmark besides superior turbinate during surgery.