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Results for “Sphenoid Sinusitis”

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Management of sphenoid sinus cerebrospinal fluid rhinorrhea: making use of an extended approach to the sphenoid sinus.

OBJECTIVES: Specific information addressing the management of cerebrospinal fluid (CSF) fistulas that originate from within the sphenoid sinus remains scant. The objective of this study was to review the cause and management of CSF rhinorrhea arising from the sphenoid sinus. STUDY DESIGN AND SETTING: This is a retrospective chart review of 12 cases of CSF rhinorrhea arising from the sphenoid sinus that occurred in 11 patients. All patients were treated at a single institution between 1994 and 1999. RESULTS: All patients were managed surgically with sphenoid sinus fat obliteration using an endoscopic sublabial, transseptal approach. This approach was successful for all 12 cases, with median duration of follow-up of 18 months. CONCLUSIONS: Endoscopically assisted transseptal repair of CSF fistulas that originate within the sphenoid sinus offers an alternate approach to previously described methods of repair in this region. Advantages include wide access to the entire sphenoid sinus, improved access to laterally pneumatized regions within the sphenoid sinus, and rostral mucosal closure over the repair within the sinus.

Adult↗

Paranasal sinus radiology, Part 3B: Sphenoidal sinus.

Mucoceles involving the sphenoidal sinus are not as common as those affecting the frontal and ethmoidal sinuses. The subtle expansile change produced by a sphenoidal sinus mucocele often requires conventional tomography or computed tomography examination to be detected. Similarly, involvement of surrounding structures by a sphenoidal mucocele may require special study, which this section illustrates. The sphenoidal enlargement and density change produced by fibrous dysplasia may mimic sinus disease. Focal or widespread bone destruction resulting from neoplastic involvement of the sphenoidal sinus requires special examination similar to that used with mucoceles.

Carcinoma↗

Paranasal sinus radiology, Part 3A: sphenoidal sinus.

This article describes the complex anatomy of the sphenoid bone. The development and size of the sphenoidal sinuses are quite variable and complete analysis of the sinus walls requires several views. The essential plain film projections and use of tomography and CT scans are described. Sphenoidal sinus inflammatory disease produces changes similar to those already discussed in the articles in this series on the frontal sinus and the ethmoidal sinus. Illustrations of sphenoidal sinus inflammatory disease are provided.

Humans↗

Mucocele of the sphenoid sinus.

The sphenoid sinus is the least common site of mucocele of all paranasal sinuses. It is very rare in children, especially in those younger than 12 years when pneumatization of the sphenoid sinus is completed. We report a case of histologically proven sphenoidal mucocele in a 5-year-old child. The child presented with an acute onset of significant visual impairment and headache. His vision gradually improved after trans-nasal sphenoidotomy and drainage of the sinus content with return of complete normal baseline vision after 2 months.

Child, Preschool↗

[Thrombophlebitis of left cavernous sinus secondary to acute right sphenoid sinusitis].

Isolated sphenoid sinusitis is a rare, potentially destructive entity. Presenting symptoms are often vague and non-specific therefore the diagnosis is made late when complications have had already occurred. The most frequent complications of sinusitis are the neurological ones--being serious life--threatening conditions. We report a case of isolate right sphenoid sinusitis with concurrent thrombophlebitis of left cavernous sinus. Accordingly, we review the salient clinical features of this illness, with emphasis on the importance of a high index of suspicion, the potentially rapid and fatal course of the disease process and the aspects of the diagnosis and treatment. We also reviewed the predisposing factors of complications of sphenoid sinusitis.

Adrenal Cortex Hormones↗

[Sphenoid sinus surgery].

Sphenoid sinus surgery due to specific localization is placed in otolaryngologists and neurosurgeons field of interest. Surgery of this area, from one side, causes number of problems, which usually arise due to close neighbourhood of important structures, but on the other, serves as alternative approach, eliminating necessity of extended operations with craniotomies. The article summarizes results of sphenoid sinus surgery at ENT Department, University of Medical Sciences in Poznan between 1990 and 2003, as well as points out characteristic features of the surgery in this specific localization.

Female↗

Isolated sphenoid sinusitis.

Isolated sphenoid sinusitis is an uncommon but potentially catastrophic infectious disease. The authors present 12 patients with acute, isolated sphenoid sinusitis and describe their presenting features and clinical courses. All patients experienced headache, facial pain, or both. Fever and leukocytosis were uncommon. Plain sinus radiographs and cranial computerized tomography scan were diagnostic. All patients were treated with antibiotics and recovered without infectious or neurological complications.

Acute Disease↗

Surgical approaches to the sphenoid sinus.

The sphenoid sinus can be approached through the ethmoid, nasal or septal zones of the anterior wall. Case studies, fresh/fixed cadaver material and radiologic examinations, including three-dimensional CT reconstructions, were used to define the anatomic conditions governing the safest penetration of each zone. The ethmoid zone was often associated with anatomic variations such as posterior and superior placement of ethmoid cells which dictated caution. The transnasal route was best used for isolated sphenoid disease since nasal disease caused significant bleeding. A detailed description of the vomer-ethmoid relationship outlines the advantages of using the septal zone. The actual zone used to enter the sphenoid sinus must be determined by the nature of the disease process to be treated and therefore a detailed knowledge of the normal and aberrant anatomy of each zone, as elaborated by the radiological road map, is required to prevent complication.

Endoscopy↗

Cavernous sinus thrombophlebitis secondary to sphenoid sinusitis.

Cavernous sinus thrombosis is a serious life threatening condition which usually results from midfacial skin infections. Preantibiotic era mortality rates of 80% have improved markedly because of an early awareness of the condition and prompt initiation of parenteral antibiotics. Sphenoid sinusitis is an uncommon associated cause of cavernous sinus infection and is itself a rare and elusive clinical problem. A case of sphenoid sinusitis and concurrent cavernous sinus thrombophlebitis is presented to highlight the clinical diagnostic considerations with special emphasis on bilateral eye signs as indicators of the impending thrombophlebitic process.

Adolescent↗

Cavernous sinus thrombophlebitis caused by sphenoid sinusitis--report of autopsy case.

A 34-year-old man developed fever, headache, nausea, double vision, exophthalmus, ptosis, disturbance of vision and oculomotor nerve palsy. Magnetic resonance imaging and cerebral angiography led to the clinical diagnoses of cavernous sinus thrombophlebitis and suspicion of bacterial aneurysm of the left internal carotid artery, respectively. Peptostreptococcus was detected in blood culture analysis. He died 15 days after admission. Systemic organs showed several septic changes. In particular, the bilateral cavernous sinuses were enlarged and showed severe neutrophilic leukocyte infiltration of the walls and organization, recanalization and abscesses in thrombi. In anterior to the middle cranial fossa, abscess-forming, necrotic, hemorrhagic meningitis, purulent sphenoid sinusitis, pyogenic osteomyelitis of the sphenoid bone, suppurative encephalitis, and inflammatory necrosis of the hypophysis were seen. Based on these findings, we diagnosed the patient with cavernous sinus thrombophlebitis caused by sphenoid sinusitis.

Adult↗

Isolated sphenoid sinus disease.

Isolated sphenoid sinus disease is an unusual entity that is encountered infrequently. With advances in antibiotic therapy and imaging techniques, the nature of isolated sphenoid sinus disease has significantly changed. More tumors and less inflammatory disorders are being encountered. We have retrospectively reviewed the medical records of patients who had undergone sublabial transseptal sphenoidotomy for isolated sphenoid sinus disease at Allegheny General Hospital for Pittsburgh between January 1985 and July 1989. Thirteen patients were identified with isolated sphenoid sinus disease who were successfully managed with sublabial transseptal sphenoidotomy. This approach allows maximal visualization and safety with minimal morbidity.

Diagnosis, Differential↗

Functional endoscopic sinus surgery for isolated sphenoid sinus disease.

BACKGROUND: This article reviews 12 cases of isolated sphenoid sinus disease: chronic inflammatory sinusitis (7), mucoceles (2), aspergillus lesions (2), and isolated polyp (1). METHODS: Criteria for diagnosis were based on clinical symptoms, nasal endoscopic evaluation, and computed tomography (CT). Magnetic resonance imaging was used only in cases of bone erosion and when patients presented with vision problems. All patients were treated by functional endoscopic sphenoidotomy. Any postoperative complications were noted. CONCLUSION: The reported good results, on the basis of regression of functional symptoms and with nasal endoscopic and CT evaluation, suggest that intranasal sphenoidotomy under endoscopic control is a safe and effective method of treatment of nonmalignant isolated sphenoid disease. The mean follow-up is 26 months.

Adult↗

Paecilomyces variotii. An unusual cause of isolated sphenoid sinusitis.

Isolated fungal sphenoid sinusitis is an unusual head and neck infection. We describe the first reported case (to our knowledge) of Paecilomyces variotii sphenoid sinusitis. In addition, it represents one of the few reported cases of isolated fungal sphenoid sinusitis. Diagnosis and management of this condition are described. Aggressive surgical management is advocated when fungal sphenoid sinusitis is suspected.

Aged↗

An unusual presentation of sphenoid sinusitis with septicaemia in a healthy young adult.

Streptococcus pneumonia and Haemophilus influenzae account for more than 50% of bacterial acute sinusitis. Isolated sphenoid sinusitis is a rare disease with potentially devastating complications such as cranial nerve involvement, brain abscess, and meningitis. It occurs at an incidence of about 2.7% of all sinus infections. There have been no previous reported cases of unilateral sphenoid sinusitis presenting as septicaemia in an otherwise healthy young immunocompetent adult.

Adult↗