Isolated Sphenoid Sinus Disease: An Analysis of 122 Cases

Abstract

Isolated sphenoid sinus disease (ISSD) is a relatively uncommon disease. The present study is a retrospective review of 122 patients with ISSD who were treated at the Department of Otolaryngology, Eye, Ear, Nose and Throat Hospital at Shanghai Medical University over a 25-year period. The diagnosis of ISSD was made on the basis of history and physical examination, signs and symptoms, nasal endoscopy, and computed tomography (CT) and magnetic resonance imaging (MRI). The final diagnosis of ISSD was confirmed by histopathologic and microbiological examinations of the surgical specimens. The pathological findings in this study included sphenoid cyst (47 cases), sphenoid sinusitis (31 cases), fungal disease (19 cases), inverted papilloma (4 cases), sphenochoanal polyp (1 case), foreign body (8 cases), malignant tumors (8 cases), and others (4 cases). The most common initial symptom was headache, followed in decreasing order by visual changes, cranial nerve palsies, and nasal symptoms. The more frequent use of routine CT and MRI scanning, as well as endoscopy, in the diagnosis of sinus disease has led to an increase in the early diagnosis of ISSD. The recent advances in endoscopic sphenoidotomy has allowed for relatively safe and immediate treatment of ISSD, preventing late extension into adjacent vital structures, which is commonly fatal. Endoscopic surgery also enables the surgeon to make a precise pathological diagnosis.

Skull Base Inverted Papilloma: A Comprehensive Review

“…Inverted papilloma originating from the sphenoid sinus can be approached via endoscopic transethmoidal sphenoidotomy [473, 474]. Endoscopic sphenoidotomy is safe, with minimal blood loss and reduced operating time, allows maximal resection with minimal morbidity and short post-operative hospitalization, allows a direct route to the sphenoid sinus, and facilitates endoscopic postoperative surveillance [46, 47, 52, 54, 337, 475–478]. Extended endoscopic frontal sinusotomy may be necessary in the management of complicated frontal sinus inflammatory disease and inverting papilloma [479].…”

Aspergilosis esfenoidal, una sospecha poco habitual

“…Cada vez podemos diagnosticar este tipo de patología con mayor prontitud y tratarlas de una manera más segura sin afectación de las estructuras adyacentes que podría comprometer el pronóstico 9 .…”

“…Por otro lado, la afectación nasal no es frecuente, lo cual nos indica que la afectación esfenoidal no tiene porqué ser consecuencia de una rinosinusitis previa 6,9,10 .…”

Isolated Sphenoid Sinus Lesions: Experience with a Few Rare Pathologies

“…Isolated sphenoid sinus lesions are uncommon, accounting for 1%–2.7% of all paranasal sinuses lesions. [1] They usually present with nonspecific symptoms and are inaccessible by physical examination. The clinical presentation involves vague headaches and may be associated with purulent rhinorrhea, retropharyngeal drip, nasal obstruction, abnormal vision, and nerve deficits.…”