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Ear, Nose, & Throat Journal Aug 2019In this article, we explore the disease spectrum and clinical characteristics of and the diagnosis and endoscopic approach to treating isolated sphenoid sinus disease...
In this article, we explore the disease spectrum and clinical characteristics of and the diagnosis and endoscopic approach to treating isolated sphenoid sinus disease (ISSD) in children. To these ends, we review a case series of 19 patients (mean age: 8.1 ± 4.9 years, range: 1.1-15 years, median age: 6.7 years, 13 males, 6 females) who underwent surgical treatment at our hospital for ISSD during the 4 years between 2012 and 2016. The symptoms of pediatric sphenoid sinus disease tend to be variable and nonspecific and include atypical headache, nasal congestion, epistaxis, postnasal drip, snoring, and impaired vision. Headache is the presenting symptom in 42% of patients, but headaches occurred in no specific or typical location. Ten patients underwent preoperative endoscopic examination, and abnormalities in the sphenoethmoidal recess were found in 6 (60%) of these 10 patients. All 19 patients underwent ultra-low-dose paranasal sinus computed tomography (CT) imaging, and 9 patients with suspected tumors or sphenoid mucoceles were further examined by magnetic resonance imaging (MRI). The endoscopic transostial approach was performed in all 19 patients: 16 patients received excision of inflammatory sphenoid sinus disorders and benign tumors, including sphenoid sinusitis, sphenoid sinus mucocele, sphenoid sinus polyp, and ossifying fibroma; 3 patients with suspected tumors received biopsies to detect rhabdomyosarcoma, Langerhans cell histiocytosis, and juvenile xanthogranuloma. No intraoperative or immediate postoperative complications were observed. Children with opacified sphenoid sinus identified by radiographic imaging presented a variety of pathologies. The most common lesions were associated with inflammatory disease. Because the symptoms of pediatric sphenoid sinus disease tend to be variable and nonspecific, CT remains the standard for evaluating sphenoid sinus disease, and ultra-low-dose paranasal sinus CT imaging is recommended and can provide images of equal or better quality compared with those obtained by standard dose CT. In addition, MRI is an essential adjunct in the diagnosis and selection of treatment for suspected tumors of the sphenoid sinus. The endoscopic transostial approach was especially suitable for the management of pediatric benign isolated sphenoid sinus lesions.
Topics: Adolescent; Child; Child, Preschool; Endoscopy; Female; Humans; Infant; Magnetic Resonance Imaging; Male; Mucocele; Nasal Polyps; Paranasal Sinus Diseases; Paranasal Sinus Neoplasms; Sphenoid Sinus; Sphenoid Sinusitis; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 31012343
DOI: 10.1177/0145561319841227 -
Ear, Nose, & Throat Journal Jul 2011
Topics: Aged, 80 and over; Aspergillus; Female; Humans; Sphenoid Sinusitis; Therapeutic Irrigation
PubMed: 21792789
DOI: No ID Found -
Otolaryngology--head and Neck Surgery :... Apr 2007We sought to study the clinical behavior and treatment outcome of isolated sphenoid sinusitis (ISS).
OBJECTIVE
We sought to study the clinical behavior and treatment outcome of isolated sphenoid sinusitis (ISS).
STUDY DESIGN AND SETTING
We conducted a retrospective study of patients diagnosed with ISS in a tertiary medical center over 20 years.
RESULTS
Of 72 patients with ISS, 79 percent had acute symptoms, 15 percent had chronic symptoms, and 6 percent had incidental radiological findings. Fifteen percent were children. Most patients were diagnosed between January and April (P < 0.01), and increasing incidence was noted over the years (P < 0.001). Headache was the most common presenting symptom (85%). Chronic patients complained also of nasal symptoms (82%). Six patients had a major complication of sinusitis (none of them were children), and two patients died. Immunocompromised patients had more major complications (P
CONCLUSION
Most patients need conservative treatment alone. However, life-threatening complications are not infrequent. Close observation and early surgical intervention, if needed, provide the mainstay of treatment.
SIGNIFICANCE
This is the first large series that focuses on the clinical behavior, complications, and treatment of ISS.
Topics: Acute Disease; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Chronic Disease; Female; Humans; Male; Middle Aged; Retrospective Studies; Sphenoid Sinusitis
PubMed: 17418260
DOI: 10.1016/j.otohns.2006.11.019 -
European Annals of Otorhinolaryngology,... Feb 2017
Topics: Cavernous Sinus Thrombosis; Diplopia; Empyema, Subdural; Eye; Headache; Humans; Jugular Veins; Magnetic Resonance Imaging; Male; Middle Aged; Sphenoid Sinusitis; Venous Thrombosis
PubMed: 27751696
DOI: 10.1016/j.anorl.2016.09.001 -
The Journal of Emergency Medicine 1990We present a case of sphenoid sinusitis resulting in a debilitating headache refractory to both oral and intramuscular analgesics. Despite an aggressive evaluation in...
We present a case of sphenoid sinusitis resulting in a debilitating headache refractory to both oral and intramuscular analgesics. Despite an aggressive evaluation in the emergency department, the correct diagnosis and appropriate treatment were delayed. Recognition of sphenoid sinusitis, the complications associated with it, and the need for aggressive management are addressed.
Topics: Adult; Headache; Humans; Male; Sphenoid Sinus; Sphenoid Sinusitis
PubMed: 2254601
DOI: 10.1016/0736-4679(90)90449-6 -
The Journal of Laryngology and Otology Feb 2009We report two extremely rare cases of isolated sphenoid 'fungal ball' in conjunction with vision loss.
OBJECTIVE
We report two extremely rare cases of isolated sphenoid 'fungal ball' in conjunction with vision loss.
METHOD
Case reports and a literature review concerning diagnosis and management of isolated sphenoid fungal ball in conjunction with vision loss.
RESULTS
A mycetoma or fungal ball resulting from isolated sphenoid fungal sinusitis is a rare disease. It is frequently difficult to diagnose, as patients present with nonspecific symptoms such as headache, visual disturbance and cranial nerve palsies. Diagnosis of the disease is typically not made until advanced imaging has been performed. We present two cases of patients with sphenoid sinus fungal ball who developed headaches and vision loss. One patient had symptoms of IIIrd cranial nerve palsy and the other partial visual field impairment. After a timely sphenoidotomy, both patients recovered fully, with resolution of all symptoms.
CONCLUSION
These two cases of sphenoid fungal ball in conjunction with vision loss suggest that the otolaryngologist should keep this disease in mind even when symptoms are nonspecific. Endoscopic surgery can be a safe and viable therapeutic approach for this condition.
Topics: Aged, 80 and over; Early Diagnosis; Female; Headache; Humans; Magnetic Resonance Imaging; Middle Aged; Mycoses; Sphenoid Sinusitis; Treatment Outcome; Vision, Low
PubMed: 19138451
DOI: 10.1017/S0022215109004241 -
BMJ Case Reports Jun 2015Isolated sphenoid sinusitis is a rare disorder and may present with complications due to its anatomical location and proximity to the intracranial and orbital contents....
Isolated sphenoid sinusitis is a rare disorder and may present with complications due to its anatomical location and proximity to the intracranial and orbital contents. It is frequently misdiagnosed, because the sphenoid sinus is not visualised adequately with routine sinus radiographs and is not accessible to direct clinical examination. We report a case who presented with hemicranial headache and ipsilateral abducens nerve palsy as the presenting feature of sphenoid sinusitis. The symptoms disappeared within a week of conservative treatment. Sphenoid sinusitis should be kept in the differential diagnosis of isolated sixth cranial nerve palsy, especially in the presence of headache, and all patients should be investigated with CT/MRI brain. Prompt diagnosis and management before intracranial extension can prevent devastating complications.
Topics: Abducens Nerve Diseases; Acute Disease; Adult; Diagnosis, Differential; Headache; Humans; Magnetic Resonance Imaging; Male; Sphenoid Sinus; Sphenoid Sinusitis; Tomography, X-Ray Computed
PubMed: 26055599
DOI: 10.1136/bcr-2015-209408 -
BMJ Case Reports Feb 2023Sphenoid sinusitis is a clinically important entity as it may be associated with catastrophic complications including cavernous sinus thrombosis (CST), cerebral abscess...
Sphenoid sinusitis is a clinically important entity as it may be associated with catastrophic complications including cavernous sinus thrombosis (CST), cerebral abscess or infarction, meningitis, base of skull osteomyelitis and cranial nerve palsies. We report a case of occult sphenoid sinusitis presenting as bacteraemia, bilateral jugular vein and CST, cranial nerve palsy and base of skull osteomyelitis.
Topics: Humans; Sphenoid Sinusitis; Cavernous Sinus; Cavernous Sinus Thrombosis; Cranial Nerve Diseases; Skull Base; Thrombosis; Osteomyelitis; Sphenoid Sinus
PubMed: 36731941
DOI: 10.1136/bcr-2022-253496 -
Ci Ji Yi Xue Za Zhi = Tzu-chi Medical... 2019Isolated sphenoid sinusitis is a rare disorder and may present with severe complications due to its proximity to the orbital and intracranial areas. We report a...
Isolated sphenoid sinusitis is a rare disorder and may present with severe complications due to its proximity to the orbital and intracranial areas. We report a 13-year-old boy hospitalized for septic shock with fever of unknown origin. Facial palsy was later noted. Brain magnetic resonance imaging showed a sphenoid mass and right cavernous sinus and internal jugular vein thrombosis. Biopsy revealed chronic rhinosinusitis. Complete recovery followed by an incision/drainage procedure and antibiotic treatment. Acute sphenoid sinusitis should be included in the differential diagnosis of septic manifestations mimicking central nervous system infection or cranial nerve palsy.
PubMed: 30692835
DOI: 10.4103/tcmj.tcmj_1_18 -
Indian Journal of Otolaryngology and... Jul 2011Isolated sphenoid sinusitis (ISS) is a rare entity. ISS accounts for about 1-2% of all sinus infections. Isolated sphenoid sinus involvement may include mucoceles,...
Isolated sphenoid sinusitis (ISS) is a rare entity. ISS accounts for about 1-2% of all sinus infections. Isolated sphenoid sinus involvement may include mucoceles, pyoceles and isolated mycotic infections. We report a case of isolated sphenoid pyocele in a 35 year-old female who presented in August 2007 with frontal and occipital headache, post nasal discharge and bilateral nasal obstruction for 6 years. CT scan showed isolated right sphenoid sinusitis. Diagnostic nasal endoscopy showed a streak of post nasal discharge on right side above the torus tubaris confirming right sphenoiditis. A cyst in the nasopharynx was incidentally detected which was confirmed by fluid aspiration to be Thornwaldt's cyst (TC). TCs have reported prevalence of 0.2-5% and though most are asymptomatic their location renders them vulnerable to infection. Sphenoidotomy was done and the cyst in the nasopharynx was removed and marsupialised. Postoperative course was uneventful.
PubMed: 22754866
DOI: 10.1007/s12070-011-0256-0