Isolated Sphenoid Sinusitis: Anatomical Features for Choosing a Method of Treatment, a Case-Control Study

Abstract

Isolated sphenoid sinusitis (ISS) is a group of pathologies characterized by inflammation in one or both sphenoid sinuses. The gold standard for analyzing and diagnosing ISS is computer tomography. Many researchers have discussed the treatment of patients with ISS variants such as fully opacified sinus, mostly with surgery. A retrospective analysis of clinical data of 59 patients (21 male (35%), 38 female (65%)) with ISS, who were treated in the Otorhinolaryngological Department of Pavlov First Saint Petersburg State Medical University between January 2017 and January 2020, was conducted. All patients were in the first stage of the same medical therapy. In cases where there was no recovery, these patients were referred to surgery. For the control group, we analyzed patients without any disorders according to CT-scan examination. After analyzing the obtained clinical and radiological data, we found indicators that were common in patients who did not recover after medical therapy. According to the reverse regression method statistical model, in male patients with a diffuse headache and nasal discharge it was shown that medical therapy was highly effective (more than 78%). The presence of nasal septum deviation and adenoids in male and female patients leads to the highest risk of surgical treatment (83% probability of the logistic model). The detailed analysis of CT-scans and the complaints of patients with ISS can be the key to determining the preferred therapy choice. Not all cases need to have an endoscopic opening of the sphenoid sinus, according to our research.

Clinical Characteristics of Sphenoid Sinus Fungus Ball: A Nine‐year Retrospective Study of 77 Cases

“…20 So, surgeons should search for fungi debris carefully especially when patients have lateral recess and posterior ethmoid sinusitis. 9 Two patients developed narrowing of sphenoid sinus ostium and sphenoid sinusitis during follow-up. After being treated with oral antibiotics and nasal irrigation for 1 week, their symptoms were relieved without the need for surgery.…”

“…FB is a rare type of paranasal sinusitis, 9 but its morbidity has been increasing in the past few decades 10–12 . This phenomenon was thought to be associated with improved diagnosis tools, increased health awareness and the wide use of antibiotics 7,10,11 .…”

“…Recurrence occurs only when surgeons fail to clean up all fungus debris during surgery 20 . So, surgeons should search for fungi debris carefully especially when patients have lateral recess and posterior ethmoid sinusitis 9 . Two patients developed narrowing of sphenoid sinus ostium and sphenoid sinusitis during follow‐up.…”