Sphenoid Sinus

Maxillary sinus nonodontogenic myxoma extending into the sphenoid sinus and pterygopalatine fossa: Case report

September 20, 2011     Süleyman Yilmaz, MD, Deniz Tuna Edizer, MD, Cengiz Yagiz, MD, Mehmet Sar, MD, and Harun Cansiz, MD


Myxomas are benign mesenchymal tumors of uncertain etiology. They can arise from odontogenic tissue, as well as from the sinonasal tract and from the facial and temporal bones, apparently from nonodontogenic mesenchyme. Although histologically benign, myxomas are locally invasive. Histopathology demonstrates a characteristically hypocellular lesion with loose stellate cells. We describe the case of a 48-year-old woman with a nonodontogenic maxillary sinus myxoma that invaded the sphenoid sinus and pterygopalatine fossa. We removed the mass via a combined endoscopic and gingivobuccal approach. The rarity of a nonodontogenic sinonasal myxoma extending into the sphenoid sinus and pterygopalatine fossa is the basis for our presentation of this case.

Bilateral sphenoid fungal sinusitis

July 13, 2011     Jae Hoon Lee, MD

Sphenochoanal polyp: Current diagnosis and management

June 30, 2010     Mohannad Ahmad Al-Qudah, MD, FICS, FAAOHNS


Choanal polyps arise from inflamed, edematous mucosa in the paranasal sinuses. They extend into the choana and cause nasal obstruction and mouth breathing. In most cases, these polyps arise in the maxillary sinus, but rare cases of origin in the sphenoid sinus and other nasal structures have been reported. The presence of a choanal polyp in an atypical location can lead to diagnostic confusion and exploration of the wrong sinus at surgery. The author reports the case of a 15-year-old girl who was diagnosed with a sphenochoanal polyp. The patient was successfully treated via an endoscopic surgical approach.

Squamous cell carcinoma arising in an inverted papilloma

April 30, 2010     Jiovani M. Visaya, BA, Julie M. Wu, MD, Eugene A. Chu, MD, and Marc G. Dubin, MD

New approach to the endoscopic repair of a CSF leak originating from the lateral recess of the sphenoid sinus

March 31, 2010     Ausama Alaani, FRCS(ORL-HNS), Patrick Jassar, FRCS(ORL-HNS), Eleanor Mein, MRCS, and Alan Phillip Johnson, FRCS


Difficult access can make identification of a cerebrospinal fluid leak from the lateral wall of the sphenoid sinus very difficult, especially in a well-pneumatized sinus. Access to the sphenoid sinus has become easier with the advancement of minimally invasive endoscopic technology. In this article we describe our approach to a cerebrospinal fluid leak originating from this location, which has not been described previously in the literature.

Isolated sphenoid sinusitis presenting as blindness

January 1, 2010     Simon Wright, MBChB and Naeem Khan, MBChB, MRCS

An acute ischemic stroke secondary to sphenoid sinusitis

October 31, 2009     Christian Adrien Righini, MD, PhD, Fabrice Bing, MD, Pierre Bessou, MD, Kamel Boubagra, MD, and Emile Reyt, MD


Acute isolated sphenoid sinusitis is a relatively uncommon entity. Because its symptoms and clinical findings are nonspecific, it can be easily misdiagnosed. Left unrecognized and untreated, it can lead to several well-known and severe complications, including meningitis, cerebral abscess, cavernous sinus thrombosis, and epidural or subdural empyema. We report the case of a 28-year-old woman with acute sphenoid sinusitis complicated by ischemic stroke in the left caudate nucleus, lentiform nucleus, and posterior part of the internal capsule. The stroke was diagnosed on magnetic resonance imaging. Also, magnetic resonance angiography showed a narrowing of the internal carotid artery and a narrowing of the first part of the left anterior and middle cerebral arteries (A1 and M1 segments). The patient was treated with medical therapy, including antibiotics, and surgical drainage of the sphenoid sinus via an endoscopic approach. Her outcome was good, and she experienced minimal neurologic sequelae. We discuss the possible explanations for this rare complication.

Adult Burkitt lymphoma originating in the sphenoid sinus: Case report and review of the literature

June 30, 2009     Sri Kiran Chennupati, MD, Satish Govindaraj, MD, Gavin Setzen, MD, and Alexander G. Chiu, MD


Burkitt lymphoma is a high-grade B-cell non-Hodgkin lymphoma. The endemic form of this malignancy occurs primarily in children aged 5 to 7 years, and it presents with jaw and facial bone involvement. The sporadic form affects older children (mean age: 12.2 yr) and often manifests as an abdominal mass; it rarely involves the head and neck. The presence of any type of lymphoma in the paranasal sinuses is rare. We report a case of Burkitt lymphoma that originated in the sphenoid sinus in a 66-year-old white woman. The patient presented with hypoesthesia in the left V1 and V2 distributions and frequent left-sided headaches. Imaging revealed that the destructive lesion had spread into the cavernous sinus and infratemporal fossa. Repeat imaging showed progression of the lesion in just 1 month. An endoscopic sphenoidotomy was performed to obtain a tissue specimen, and a diagnosis of sporadic Burkitt lymphoma was established on the basis of its clinical, morphologic, and immunohistochemical characteristics. The patient underwent chemotherapy and radiation. Short-term follow-up imaging showed that the lesion had disappeared, and the patient remained disease-free at 3 years of follow-up. This case is one of the few reported cases of true adult Burkitt lymphoma originating in the sphenoid sinus. We discuss the rapid progression of the disease and the considerable amount of invasion that can occur with minimal symptoms.

A huge sphenoid sinus mucocele: Report of a case

April 30, 2009     Bijan Khademi, MD, Behrooz Gandomi, MD, and Mehdi Tarzi, MD


Sphenoid sinus mucoceles are exceedingly rare. Most have occurred in men between the ages of 30 and 40 years. We report a case of sphenoid sinus mucocele that was unusual not only for the age of the patient (13 yr), but for the massive size of the lesion (59 x 53 mm). The patient presented with a 20-day history of unilateral proptosis, decreased vision, diplopia, and photophobia. He also complained of severe bilateral nasal obstruction, nasal stuffiness, and a mucoid nasal discharge. Endoscopic decompression of the left sphenoid sinus was performed, and approximately 200 ml of thick, sterile mucoid secretion was aspirated. Despite the size of the mucocele, no significant destruction of the sphenoid walls was evident. Postoperatively, the patient's symptoms improved significantly.

Endoscopic view of purulent sphenoid sinusitis

February 1, 2009     Dewey A. Christmas, MD, Joseph P. Mirante, MD, FACS, and Eiji Yanagisawa, MD, FACS

The use of a telescope in sinus balloon dilation

August 31, 2007     Dewey A. Christmas Jr., MD; Joseph P. Mirante, MD, FACS; Eiji Yanagisawa, MD, FACS

Balloon catheter dilation is being used to help improve paranasal sinus ventilation.1,2 Those who teach the technique emphasize the use of the C-arm fluoroscope and the tactile introduction of a sinus guidewire. This is followed by the insertion of the sinus balloon catheter over the sinus guidewire. The balloon is inflated, deflated, and withdrawn. All of this can usually be accomplished without the use of a sinus telescope. However, we have found that the use of a telescope in addition to fluoroscopy is quite helpful.

An aggressive psammomatoid ossifying fibroma of the sinonasal tract: Report of a case

June 30, 2007     Bijan Khademi, MD; Nika Niknejad, MD; Jalal Mahmoudi, MD
Aggressive psammomatoid ossifying fibromas (APOFs) represent a subgroup of related fibro-osseous lesions that appears to be unique to the nasal cavity, paranasal sinuses, and orbit. These rare lesions are characterized by distinctive histomorphologic features and a tendency to affect younger patients. Histologically they are benign, but clinically they are locally aggressive. We report the case of a 15-year-old boy who had a large APOF in the left ethmoid and sphenoid sinuses. The location of this tumor made this case unusual.
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