Sphenoid Sinus

Endoscopic view of sphenoid sinus illumination and transillumination

February 12, 2014     Ken Yanagisawa, MD, FACS; Dewey A. Christmas, MD; Joseph P. Mirante, MD, FACS; and Eiji Yanagisawa, MD, FACS
article

The sphenoid sinus has been considered a more challenging sinus to view with the lighted guide wire; unlike the other three paranasal sinuses, the sphenoid sinus is “hidden” from view because of its more posterior location.

Unusual presentations of choanal polyps: Report of 3 cases

February 12, 2014     Ali Ozdek, MD; Halil Erdem Ozel, MD
article

Abstract

Most choanal polyps arise from the maxillary sinus, and they are called antrochoanal polyps. Their typical endoscopic and radiologic appearance makes them easy to diagnose. However, some choanal polyps originate in unusual sites in the paranasal sinuses and nose, such as the sphenoid sinus and the lateral wall of the nose. These polyps usually present unilaterally, although bilateral presentations are possible. We describe 3 cases of atypical choanal polyps: a sphenochoanal polyp, bilateral antrochoanal polyps, and a giant antrochoanal polyp. In each case, nasal endoscopy and computed tomography clinched the diagnosis, and endoscopic surgery was performed to successfully remove the polyp. We discuss the clinical characteristics of these 3 cases.

The significance of magnetic resonance imaging and computed tomography findings in sphenoid sinus agenesis

February 12, 2014     Lokman Uzun, MD; Omer Faik Sagun, MD; Bulent Seferoglu, MD; Omer Etlik, MD; and Kamran Mahmutyazicioglu, MD
article

Abstract

Agenesis of the sphenoid sinuses is a very rarely encountered anatomic variation. Findings on magnetic resonance imaging can mislead the radiologist and clinician. Therefore, the gold standard for diagnosis is computed tomography (CT) of the paranasal sinuses. We present the case of a 28-year-old man who was admitted to our hospital with a 3-month history of headache. CT of the paranasal sinuses revealed isolated bilateral sphenoid sinus agenesis.

The endoscopic transnasal paraseptal approach to a sphenoid sinus osteoma: Case report and literature review

December 20, 2013     Frank Rikki Canevari, MD; Georgios Giourgos, MD; Andrea Pistochini, MD
article

Abstract

Osteomas are the most common benign tumors of the nose and paranasal sinuses. Their symptoms, which are nonspecific, occur as the result of a blocked nasal airflow or, in some rare cases, the involvement of nearby structures. Isolated sphenoid sinus osteomas are very rare, as only 20 cases have been previously reported in the literature. Most authors advise surgical treatment for symptomatic lesions. Surgical access to the sphenoid sinus has traditionally been a challenge for surgeons. We describe an endoscopic transnasal paraseptal resection of a sphenoid osteoma in a 35-year-old man. We also discuss surgical access and review the evolution of the surgical approaches to the sphenoid sinus.

Sphenoid sinus mucocele as a cause of isolated pupil-sparing oculomotor nerve palsy mimicking diabetic ophthalmoplegia

December 20, 2013     Alireza Mohebbi, MD; Hesam Jahandideh, MD; Ali Amini Harandi, MD
article

Abstract

A 37-year-old woman presented with isolated right-sided oculomotor nerve palsy. Neurologic examination revealed no other disorder. Computed tomography of the paranasal sinuses demonstrated complete opacification of the sphenoid sinus. Dense mucoid fluid was drained from the sphenoid sinus via an endoscopic transseptal sphenoidotomy. A biopsy confirmed the diagnosis of sphenoid sinus mucocele. At follow-up 4 weeks postoperatively, the patient's ocular symptoms were markedly alleviated. Considering rare causes of isolated oculomotor nerve palsy, such as sphenoid sinus mucocele, is important in the differential diagnosis, even in patients with well-known risk factors such as diabetes mellitus.

Endoscopic view of the sphenoid sinus seen through the posterior ethmoid sinus

October 23, 2013     Joseph P. Mirante, MD, FACS; Dewey A. Christmas, MD; Eiji Yanagisawa, MD, FACS
article

Care must be taken when entering the sphenoid sinus, to dissect inferiorly and medially to avoid injury to the vital structures of the lateral wall of the sphenoid sinus.

Progressive blindness caused by an unusual sphenoid sinus dehiscence

September 18, 2013     Mariana Marquez, MD; Enrique Palacios, MD, FACR; Jeremy Nguyen, MD; Harold R. Neitzschman, MD, FACR, FACNM, FAAP
article

The optic nerve and other important structures in the anterior skull base can be involved in chronic sphenoidal sinus disease.

Endoscopic view of the posterior septal branch of the sphenopalatine artery

April 17, 2013     Jae Hoon Lee, MD
article

Moderate posterior epistaxis can be avoided if the posterior septal branch of the sphenopalatine artery is accounted for when extending the natural ostium inferiorly to a distance greater than approximately 5 mm.

Renal cell carcinoma metastatic to the sinonasal region: Three case reports with a review of the literature

October 31, 2012     Pradipta Kumar Parida, MS, DNB, MNAMS
article

Abstract

The paranasal sinuses are a rare location for metastases. The most frequent infraclavicular primary tumor to metastasize to the nose and paranasal sinuses is renal cell carcinoma. Three cases of bilateral renal cell carcinoma with metastases to the paranasal sinuses and with destruction of the skull base are reported. These patients had a primary renal cell carcinoma on the left side for which they had undergone a left nephrectomy many years previously. Right-sided renal cell carcinoma was diagnosed only after the patients had developed symptoms secondary to their metastases. These patients presented with the unusual manifestations of frontal swelling, proptosis, and epistaxis. They were offered palliative treatment in the form of radiotherapy and interferon therapy.

Sphenoethmoid sinusitis in a child resulting in a disastrous intracranial sequela

October 31, 2012     Aye Jane Sow, MS(ORL-HNS); Jeevanan Jahendran, MS(ORL-HNS); Charng Jeng Toh, MS(Neurosurg); Thean Yean Kew, FRCR
article

Abstract

Localized sphenoethmoid sinusitis in children is a rare occurrence. It is usually overlooked because of the misconception that the sinuses are not developed. We describe a case of localized acute sphenoid and right posterior ethmoid sinusitis that presented as right frontobasal subdural empyema and multiple deep cerebral abscesses. Morbidity from subdural empyema in children is high. Early diagnosis and treatment based on recognition that the etiology might involve the paranasal sinuses affects the overall prognosis.

Staphylococcus aureus cavernous sinus thrombosis mimicking complicated fungal sinusitis

July 5, 2012     Murat Songu, MD; Nazan Can, MD; Kazim Onal, MD; Secil Arslanoglu, MD; Nezahat Erdogan, MD; Aylin Kopar, MD; Ejder Ciger, MD
article

Abstract

Septic cavernous sinus thrombosis is a rare and potentially life-threatening complication of infections involving the paranasal sinuses or the middle one-third of the face. We report a challenging case of cavernous sinus thrombosis to familiarize otolaryngologists with its clinical features, diagnosis, and management. The patient was a 45-year-old diabetic woman whose signs and symptoms mimicked those of complicated fungal sinusitis. She presentedwith fever, nausea without vomiting, frontal headache, bilateral ptosis and swelling, double vision, a partial loss of visual acuity in the left eye, and restricted lateral ocular movements. Her Snellen visual acuity had been reduced to 8/10 on the right and 6/10 on the left. Radiologic investigation revealed cavernous sinus extension of sphenoid sinusitis and a fungus-ball appearance in the sphenoid sinus. On the second day of her admission, the patient’s vision was further reduced to 6/10 on the right and 2/10 on the left. She then underwent urgent bilateral anterior and posterior ethmoidectomy and sphenoidectomy. At postoperative follow-up, her vision had stabilized at 10/10 bilaterally. At 2 months after discharge, she exhibited no evidence of abducens nerve palsy, and her ocular function had returned to normal. The diagnosis of cavernous sinus thrombosis requires a high index of suspicion and confirmation by imaging. The favorable outcome in our case was attributable to early diagnosis, prompt initiation of appropriate intravenous antibiotic therapy, and surgical drainage by the skillful surgical team.

Endoscopic view of sphenoid sinusitis adjacent to an intracranial aneurysm

July 5, 2012     Dewey A. Christmas, MD; Joseph P. Mirante, MD, FACS; Eiji Yanagisawa, MD, FACS
article

Cases of isolated sphenoid sinusitis unresponsive to medical therapy can be treated endoscopically using sinus balloon dilation.

Page
of 4Next