Forty‐five patients with isolated sphenoid sinus lesions were seen at the Mayo Clinic between 1935 and 1972. The types of lesions that these patients had included inflammatory lesions (chronic sphenoid sinusitis and mucopyoceles), tumors, fibrous dysplasia, rhinoliths, and sphenoid polyp. A review of the anatomy and important structures contiguous to the sphenoid sinus reflected the range and progression of clinical symptoms. Complications included pain or headache, visual disturbance including blurred vision, diplopia, exophthalmos, blindness, meningitis, and even death. The most frequent presenting symptoms were headache, retro‐orbital pain, nasal congestion, and visual disturbance, especially diplopia. Some time during the course of the illness, 40. percent of the patients developed visual involvement. Diagnosis was made with the aid of the patient's history and physical examination, whereas the laboratory studies usually were negative, and roentgenographic findings ranged from thickening to fluid levels and bony erosion or frank destruction of the floor of the sella. Fifteen percent of the roentgenograms were false‐negatives, all of which were noted in patients with inflammatory lesions. The differential diagnosis includes pituitary lesions, although the clinical features, the bitemporal hemianopsia, and hypopituitary function, which are characteristic of pituitary tumors, are absent in isolated sphenoid sinus lesions. Mild degrees of panhypopituitarism may exist with inflammatory lesions of the sphenoid sinus. Definitive diagnosis and therapy are usually effected by transnasal exploration of the sphenoid sinus.
During a 20-year period, 12 patients with nontraumatic, nonneoplastic subglottic stenosis were seen at the Mayo Clinic. The etiologic factors were relapsing polychondritis, amyloidosis, sarcoidosis, and Wegener's granulomatosis. Because of the diverse initial presentation of the disease, the clinician should consider that the stenosis is a manifestation of a systemic disorder and carry out an otolaryngologic and physical examination with the appropriate roentgenograms and blood and urine tests. Treatment, if a systemic disease is proved, consists of appropriate medication. Surgery may be necessary, depending on the nature of the lesion. Small strictures may not need to be treated.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.