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Isolated Sphenoid Sinus Disease: The MERF Experience

Kiran Natarajan, Thangammal Begum, Ronald Anto, Adarsh Panicker, Raghunandhan Sampath Kumar and Mohan Kameswaran

Introduction: Isolated disease of the sphenoid sinus is rare and represents 1 to 2% of all sinus disease. Symptoms can be vague and patients may present with headache, rhinorrhea and postnasal drip. Early identification and management is crucial to avert potential intracranial and ophthalmic complications.

Methods: A retrospective study of isolated sphenoid sinus disease was done in a tertiary ENT centre between Jan 1998 to Jan 2018 and the etiology, diagnosis and management of the various lesions was systematically evaluated.

Results: Forty seven cases of isolated sphenoid disease treated between Jan 1998 to Jan 2018 were evaluated by ENT examination, diagnostic nasal endoscopy, computed tomography of the paranasal sinuses, and in some cases with magnetic resonance imaging as needed. The most common symptom was headache (72%). The various etiologies included Allergic fungal rhino sinusitis (AFRS) (36%), acute or chronic inflammation (26%), mucocele (23%), cerebrospinal fluid leak (6%), sphenochoanal polyps (4%),coexisting mucocele with fungal sinusitis (2%) and giant cell reparative granuloma (2%). Endoscopic surgery was effective in treating all the cases of isolated sphenoid sinus disease. Conclusion: Awareness of the potential neuro-ophthalmic complications of sphenoid sinus disease is crucial. The key to successful management of isolated sphenoid sinus disease is early identification of the subclinical manifestations and timely treatment.