Surgical treatment of isolated sphenoid sinusitis - A case series and review of literature

Vomer‐Rostrum Mucosal Flap for Exposed Bone Coverage After Sphenoid Sinusotomy

“…Recurrence of sphenoid sinusitis after surgery ranges somewhat in the literature from 0% to 18%. In a case series and review of literature Villemure‐Poliquin and Nadeu suggest that short‐term follow‐up and small numbers of patients likely account for underreporting of recurrences in sphenoid sinus surgery 1 . To address cases of failed sphenoidotomy, advanced disease or extensive hyperostosis, Soler et al described endoscopic sphenoid nasalization which included a wide bilateral sphenoidotomies and drill out.…”

“…In a case series and review of literature Villemure-Poliquin and Nadeu suggest that short-term follow-up and small numbers of patients likely account for underreporting of recurrences in sphenoid sinus surgery. 1 To address cases of failed sphenoidotomy, advanced disease or extensive hyperostosis, Soler et al described endoscopic sphenoid nasalization which included a wide bilateral sphenoidotomies and drill out. They compared conceptually to a frontal sinus drill out to create a wide outflow tract and reduce the risk of complete scarring of the sinus.…”

“…If left unrecognized these pathologies can lead to complications of intracranial abscess, cavernous sinus thrombosis, or blindness. 1 Recurrence of sphenoid sinus opacification after operative intervention can occur due to scarring or bone remodeling and reported to be 10% which may even more pronounced in the setting of mucoceles and fungus balls (see Fig. 1).…”

“…Differential diagnosis for inflammatory lesions in the sphenoid includes bacterial sinusitis, mucocele, fungus ball, and allergic fungal sinusitis. If left unrecognized these pathologies can lead to complications of intracranial abscess, cavernous sinus thrombosis, or blindness 1 …”

“…1). 1 The bone remodeling phenomenon has been described in the frontal sinus with restenosis following endoscopic modified Lothrop procedures 2 . Recent studies have found that placement of vascularized flaps or mucosal grafts resulted in reduced rates of stenosis and neoossification 2 …”