Isolated Sphenoid Sinus Lesions

Year 2019, Volume: 2 Issue: 2, 41 - 44, 08.10.2019

Esra Aydın Ayşe Öznur Akidil Günay Ateş Evren İbrahim Sayın , Selçuk Güneş , Zahide Mine Yazıcı

Abstract

Objective: The aim of this study was to compare the clinical radiological and pathological results of pathologies detected in isolated sphenoid sinus lesions.

Material and Methods: Six patients with sphenoid sinus lesions admitted to the Otorhinolaryngology and Head and Neck Surgery Clinic between July 2017 and October 2018 were retrospectively analyzed. Demographic characteristics, clinical findings, imaging findings, surgical treatment methods, and histopathological diagnosis were analyzed. The study was accepted by the Ethics Committee (Code, 2019/414; dated 02/09/2019).

Results: The age range of the patients was between 18 and 71 years, the median age of the patients was 30.5 (between 18 and 71) years. The most common presenting complaints were headache (6/6), nasal obstruction (1/6), and postnasal discharge (1/6). Nasal endoscopic examination revealed purulent discharge in the middle meatus in two cases (2/6). One patient had septal deviation and concha hypertrophy (1/6). Examination was normal in two cases (2/6). Surgical intervention was performed in five patients (5/6). Follow-up was recommended in one patient (1/6) due to response to medical treatment. The pathological results of the patients who underwent surgery were sphenoid sinusitis in two cases, sphenoid sinus cyst in two cases, high-grade B cell lymphoma in one case, and chordoma in one case.

Conclusion: Isolated sphenoid lesions are the most common headache complaints, and the lack of findings on physical examination leads to delay in diagnosis. In cases of clinical suspicion and in cases resistant to medical therapy, imaging methods should be performed with computed tomography and/or magnetic resonance imaging. Surgery is the primary treatment approach, and definitive diagnosis is made by histopathological analysis.

Keywords

Sphenoid sinus , sphenoid sinusitis , endoscopic sinus surgery

References

• Wang ZM, Kanoh N, Dai CF, Kutler DI, Xu R, Chi FL, et al. Isolated sphenoid sinus disease: an analysis of 122 cases. Ann Otol Rhinol Laryngol 2002; 111: 323-7.
• Ruoppi P, Seppa J, Pukkila M, Nuutinen J. Isolated sphenoid sinus diseases: report of 39 cases. Arch Otolaryngol Head Neck Surg 2000; 126: 777-81.
• Nour YA, Al-Madani A, El-Daly A, Gaafar A. Isolated sphenoid sinus pathology: spectrum of diagnostic and treatment modalities. Auris Nasus Larynx 2008; 35: 500-8.
• Branstetter BF 4th, Weissman JL. Role of MR and CT in the paranasal sinuses. Otolaryngol Clin North Am 2005; 38: 1279-99.
• Ng YH, Sethi DS. Isolated sphenoid sinus disease: differential diagnosis and management. Curr Opin Otolaryngol Head Neck Surg 2011; 19: 16-20.
• Kim SW, Kim DW, Kong IG, Kim DY, Park SW, Rhee CS, et al. Isolated sphenoid sinus diseases: report of 76 cases. Acta Otolaryngol 2008; 128: 455-9.
• Dolapsakis C, Kranidioti E, Katsila S, Samarkos M. Cavernous sinus thrombosis due to ipsilateral sphenoid sinusitis. BMJ Case Rep 2019; 12: doi: 10.1136/bcr- 2018-227302.
• Xiong M, Moy WL. Orbital Apex Syndrome Resulting from Mixed Bacterial Sphenoid Sinusitis. Eur J Case Rep Intern Med 2018; 4: doi: 10.12890/2018_000905.
• Choo YS, Ting E, Tong KM, Hallinan JTPD. Internal carotid artery aneurysm secondary to fungal sphenoid sinusitis. Int J Infect Dis 2018; 76: 32-4.
• Fawaz SA, Ezzat WF, Salman MI. Sensitivity and specificity of computed tomography and magnetic resonance imaging in the diagnosis of isolated sphenoid sinus diseases. Laryngoscope 121: 1584-9.
• Branstetter BF 4th, Weissman JL. Role of MR and CT in the paranasal sinuses. Otolaryngol Clin North Am 2005; 38: 1279-99.
• Friedman A1, Batra PS, Fakhri S, Citardi MJ, Lanza DC. Isolated sphenoid sinus disease: etiology and management. Otolaryngol Head Neck Surg 2005; 133: 544-50.
• Tang IP, Brand Y, Prepageran N. Evaluation and treatment of isolated sphenoid sinus diseases. Curr Opin Otolaryngol Head Neck Surg 2016; 24: 43-9.