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The Journal of Craniofacial Surgery Nov 2018Improvements in computed tomography and in functional endoscopic sinus surgery have recently increased interest toward paranasal sinus anatomy and anatomic variations...
Improvements in computed tomography and in functional endoscopic sinus surgery have recently increased interest toward paranasal sinus anatomy and anatomic variations that can be observed in patients affected by sinusitis. Isolated sphenoid sinusitis is a relatively rare pathology, often related to nonspecific symptoms, therefore making diagnosis difficult. The correlation between this type of sinusitis and anatomical variants remains unclear.The authors' aim was to retrospectively revise paranasal sinuses computed tomography scans of patients affected by sphenoid sinusitis, compared with a control group, analyzing the types of sphenoid sinus and the presence of aberrant pneumatization, and performing a segmentation of the sphenoid sinuses to calculate the volumes.Sphenoid sinuses of 60 patients affected by sinus opacification, compared with a control group, were segmented. Type of sinus (sellar, presellar, postsellar) and presence of aberrant pneumatization were assessed as well. Possible statistically significant differences in volumes according to sex and group were assessed through 2-way ANOVA test (P < 0.05). Post-hoc test was assessed through Student t test. χ test was applied in order to verify the statistically significance of differences in frequency of different types of sinus pneumatization variants (P < 0.05).Average volume of sphenoid sinuses in males was of 7.672 cm and of 7.751 cm in females within the group of patients; statistically significant differences in volume were found according to sex (P: 0.342), but not between the patients and control group (P: 0.0929). Post-hoc test verified that males affected by sinus opacification showed smaller volumes in comparison with the control males (P < 0.05). In addition, patients by affected sinus opacification showed more frequently the postsellar type and were less affected by pneumatization variants of the sphenoid bone than the control group (P < 0.05).This study first suggests the possible protective role of variants of pneumatization in the development of sphenoid sinus opacification.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Retrospective Studies; Sphenoid Sinus; Sphenoid Sinusitis; Tomography, X-Ray Computed; Young Adult
PubMed: 30277947
DOI: 10.1097/SCS.0000000000004797 -
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke... Dec 2015To analyze the possible influence factors of sphenoid sinusitis after endoscopic transsphenoidal sellar surgery.
OBJECTIVE
To analyze the possible influence factors of sphenoid sinusitis after endoscopic transsphenoidal sellar surgery.
METHODS
A retrospective analysis of 177 patients who underwent transsphenoidal sellar surgery, from January 2009 to January 2014 in Tianjin Huanhu Hospital was performed. All patients were followed up with nasal endoscope. The risk factors of sphenoid sinusitis after surgery were analyzed statistically, such as sex, age, categories of disease, surgical produres, tumor size, using artificial or self material repair, with or without EC glue intraoperatively, etc. SPSS 17.0 software was used to analyze the data.
RESULTS
After surgery, there were 34 (19.2%) patients developed postoperative sinusitis. EC glue was the sole risk factor for postoperative sinusitis (34.57% vs 6.25%, χ(2)=22.701, P<0.01), but the sex, age, categories of disease, surgical produres, tumor size and patching material had no significant difference (all P>0.05).
CONCLUSIONS
In patients with endoscopic transsphenoidal sellar surgery, regular postoperative nasal endoscopic follow-up found that the use of EC glue was the risk factor for the development of postoperative sphenoid sinusitis.
Topics: Adhesives; Endoscopy; Humans; Nasal Cavity; Pituitary Neoplasms; Postoperative Period; Retrospective Studies; Risk Factors; Sella Turcica; Sphenoid Sinusitis
PubMed: 26888131
DOI: No ID Found -
Practical Neurology Aug 2020
Topics: Abducens Nerve Diseases; Aspergillosis; Female; Humans; Middle Aged; Sphenoid Sinus; Sphenoid Sinusitis
PubMed: 32075878
DOI: 10.1136/practneurol-2019-002478 -
Archives of Otolaryngology--head & Neck... Jul 2007To assess the role of multidetector computed tomography (CT) and CT virtual sinoscopy in the evaluation of chronic sphenoid sinusitis and to compare the imaging findings... (Comparative Study)
Comparative Study
OBJECTIVES
To assess the role of multidetector computed tomography (CT) and CT virtual sinoscopy in the evaluation of chronic sphenoid sinusitis and to compare the imaging findings with functional endoscopic sinus surgery.
DESIGN
Prospective study.
SETTING
Tertiary care teaching hospital.
PATIENTS
Thirty patients with chronic sphenoid sinusitis referred for preoperative CT.
INTERVENTIONS
Thin-section helical axial CT was performed using a multidetector CT scanner with multiplanar reformation (MPR) and volume-rendered or virtual sinoscopy images. Sixty sinuses were divided into quadrants for analysis. Extrasinus extension was labeled as the "fifth quadrant."
MAIN OUTCOME MEASURES
Imaging findings were compared with those of functional endoscopic sinus surgery, and accuracy of the imaging modality was determined.
RESULTS
Multidetector CT (axial CT and MPR) was found to be 100% sensitive, specific, and accurate in the evaluation of extent of sinusitis, status of the sinus septum, integrity of the optic nerve canal in relation to the sinus, and type of sinus pneumatization. Axial CT and MPR images showed sensitivity of 98% and specificity of 92% compared with functional endoscopic sinus surgery in evaluating the ostia. Regarding carotid canal integrity, axial CT and MPRs were 100% sensitive and 98% specific. Virtual sinoscopy showed sensitivity and specificity of 67% and 92%, respectively, for the 22 ostia that could be visualized and evaluated using this modality.
CONCLUSIONS
Axial multidetector CT with secondary MPRs provide the necessary preoperative information regarding extent of disease and sphenoid sinus anatomy. Virtual sinoscopy is a navigational aid, an adjunct to endoscopy, and an educational tool for surgeons-in-training.
Topics: Adolescent; Adult; Aged; Child; Chronic Disease; Endoscopy; Female; Humans; Image Processing, Computer-Assisted; Male; Middle Aged; Preoperative Care; Prospective Studies; Sensitivity and Specificity; Sphenoid Sinus; Sphenoid Sinusitis; Tomography, X-Ray Computed
PubMed: 17638786
DOI: 10.1001/archotol.133.7.710 -
Otolaryngologia Polska = the Polish... 2014Isolated acute sphenoid sinusitis is an uncommon sinus infection, frequently misdiagnosed and not usually considered in the differential diagnosis of acute severe...
INTRODUCTION
Isolated acute sphenoid sinusitis is an uncommon sinus infection, frequently misdiagnosed and not usually considered in the differential diagnosis of acute severe headache, with the potential of serious neurologic complications.
AIM
Describe four patients with acute sphenoid sinusitis who presented with acute onset of severe headache and consider the role of medical or surgical management. Two patients do not required surgical intervention and medical treatment was sufficient. One patient had sphenoidotomy due to meningitis. One patient was performed surgical intervention after fail of medical therapy. Acute isolated sphenoid sinusitis appears to be difficult to diagnose. It is important to be aware of acute sphenoid sinusitis in the setting of new onset severe headache, when imaging studies are unrevealing for intracranial pathology. Medical therapy focused on infection, inflammation, and obstruction may be adequate for resolution, but surgical intervention may be required in certain situations.
Topics: Adult; Female; Headache; Humans; Meningitis; Middle Aged; Sphenoid Sinus; Sphenoid Sinusitis; Young Adult
PubMed: 24629743
DOI: 10.1016/j.otpol.2012.09.002 -
The Laryngoscope Aug 2001Meningitis is the most common intracranial complication of sinusitis. We review the incidence, current management, outcomes, and complications of this serious infection....
OBJECTIVES
Meningitis is the most common intracranial complication of sinusitis. We review the incidence, current management, outcomes, and complications of this serious infection. Our study also examines the evolving roles of endoscopic sinus surgery and other new therapeutic and diagnostic modalities in our armamentarium.
STUDY DESIGN
A retrospective chart review was performed at a tertiary academic medical center of all patients diagnosed with sinusitis with complications between January 1985 and December 1999.
METHODS
The patients were divided into two main groups: intracranial versus orbital complications. Meningitis was the most common intracranial complication. Data on patients with sinusitis and meningitis were collected and analyzed.
RESULTS
Intracranial complications were present in 39 of 82 patients whereas orbital complications were noted in 43 patients. Twenty-one of the 39 intracranial complications were meningitis. The most common computed tomography finding in adults (54%) was sphenoid sinusitis. All patients with AIDS (6 of 21) had unique cryptococcus meningitis. In patients without AIDS, the most common organism was Streptococcus pneumoniae (10 of 21). The most common sequela was seizure disorder (4 of 21). Endoscopic sinus surgery was performed on 7 of 21 patients. One patient with AIDS who had sinusitis and meningitis died.
CONCLUSIONS
Meningitis as a complication of sinusitis may still pose a serious threat. Although outcomes are encouraging, sequelae such as seizure disorders and hearing loss are common complications. The introduction of high-resolution computed tomography scans and magnetic resonance imaging and the availability of wide-spectrum antibiotics have improved our management significantly.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Endoscopy; Female; Humans; Infant; Male; Meningitis, Bacterial; Meningitis, Cryptococcal; Middle Aged; Retrospective Studies; Sinusitis; Sphenoid Sinusitis; Tomography, X-Ray Computed
PubMed: 11568566
DOI: 10.1097/00005537-200108000-00006 -
The Laryngoscope Dec 1997Solitary involvement of the sphenoid sinus is a relatively uncommon entity. A series of 132 patients with isolated sphenoid disease accumulated over a 22-year period is... (Comparative Study)
Comparative Study Review
Solitary involvement of the sphenoid sinus is a relatively uncommon entity. A series of 132 patients with isolated sphenoid disease accumulated over a 22-year period is reported. A retrospective chart review was performed with special attention to the patients' presenting signs, symptoms, and radiographic findings. There were 80 patients with inflammatory disease, 38 with neoplasms, four with fibroosseous disorders, and 10 with traumatic and developmental lesions. The most common presenting symptom was headache, followed by visual changes and cranial nerve palsies. Cranial nerve abnormalities were encountered in 12% of the inflammatory cases, 60% of the benign tumors, and 57% of the malignant tumors. Radiographically, bone remodeling was associated with chronic inflammatory disease, especially mucoceles. Bone erosion was found principally with neoplastic disease, occurring rarely with mucoceles. Extension was associated with malignant tumors.
Topics: Adolescent; Aged; Algorithms; Cerebral Palsy; Child; Chronic Disease; Cranial Nerves; Female; Fibrous Dysplasia of Bone; Headache; Humans; Male; Middle Aged; Retrospective Studies; Severity of Illness Index; Skull Neoplasms; Sphenoid Sinusitis; Vision Disorders
PubMed: 9396670
DOI: 10.1097/00005537-199712000-00003 -
The Journal of Laryngology and Otology May 2000Isolated sphenoid fungal sinusitis is a rare and often difficult to diagnose condition as the presenting symptoms are often vague and non-specific. In this series each...
Isolated sphenoid fungal sinusitis is a rare and often difficult to diagnose condition as the presenting symptoms are often vague and non-specific. In this series each case has a different clinical presentation with a different causative fungus. Although isolated fungal sphenoid sinusitis is usually seen in immunocompromised individuals, two of the three cases presented were immunocompetent. The fungi were Pseudallescheria boydii, Aspergillus fumigatus and Schizophyllum commune. In order to illustrate the great diversity of clinical signs, each case is individually presented. The characteristic radiological signs and the clinical management of each case are also presented. The danger signs of associated pathology are discussed with particular reference to an associated squamous carcinoma in one case. Surgical options and chemotherapy are discussed. Isolated sphenoid fungal sinusitis is a rare condition that if undiagnosed may result in considerable morbidity and even mortality of patients.
Topics: Adult; Aged; Aged, 80 and over; Aspergillosis; Aspergillus fumigatus; Female; Humans; Middle Aged; Mycoses; Pseudallescheria; Schizophyllum; Sphenoid Sinusitis; Tomography, X-Ray Computed
PubMed: 10912273
DOI: 10.1258/0022215001905643 -
International Journal of Pediatric... Apr 2004Isolated sphenoid sinusitis is a rare disorder. There are some difficulties in its diagnosis and the first presentation of this disorder might be with complications....
Isolated sphenoid sinusitis is a rare disorder. There are some difficulties in its diagnosis and the first presentation of this disorder might be with complications. These complications are essentially due to the anatomical location of the sinus and its proximity to the intra-cranial and orbital contents, to which infection may easily spread. In this paper, we report a case of isolated sphenoid sinusitis in a 12-year-old girl who was presented with unilateral VIth nerve palsy. She was initially treated with parenteral antibiotherapy, the abducens nerve palsy recovered but as sphenoiditis persisted she underwent an endoscopic sphenoidotomy. We discuss the clinical features, the diagnostic tools, and the treatment options for this entity.
Topics: Abducens Nerve Diseases; Child; Endoscopy; Female; Humans; Magnetic Resonance Imaging; Sphenoid Sinusitis; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 15013621
DOI: 10.1016/j.ijporl.2003.11.011 -
The Annals of Otology, Rhinology, and... Apr 2003Isolated inflammatory disease of the sphenoid sinus is very uncommon in the pediatric population. A 10-year review of all patients at our institution 16 years of age or...
Isolated inflammatory disease of the sphenoid sinus is very uncommon in the pediatric population. A 10-year review of all patients at our institution 16 years of age or younger with inflammatory sphenoid sinus disease found 8 patients with isolated sphenoid sinusitis and 3 with sphenoid mucoceles. The most common symptoms were headache and visual disturbance. Five patients with uncomplicated sinusitis were successfully managed medically, while 3 with either complicated sinusitis or sinusitis not responding to antibiotics were treated by endoscopic sphenoidotomy. All patients with a mucocele were treated surgically. Isolated inflammatory sphenoid sinusitis should be considered in children age 7 years or older who present with headache that does not respond to simple analgesia. Delayed diagnosis and advanced disease may lead to life-threatening complications.
Topics: Adolescent; Anti-Bacterial Agents; Bacterial Infections; Child; Drug Resistance; Female; Headache; Humans; Male; Mucocele; Retrospective Studies; Sphenoid Sinusitis; Vision Disorders
PubMed: 12731634
DOI: 10.1177/000348940311200413