BACKGROUND AND OBJECTIVES: The sphenoidotomy removing inferomedial side of anterior sphenoid wall has been the standard procedure to enter the sphenoid sinus. In this paper, we evaluated the feasibility and safety of superolateral sphenoidotomy based on the radiological analysis of the sphenoid sinus. SUBJECTS AND METHOD: Seventy-six multiplanar reconstructive computed tomography (CT) scans were reviewed to investigate dimensions of the sphenoid sinus. We measured the length from sphenoid ostium to optic canal and to carotid artery, and also measured the thickness of both upper and lower bony part of sphenoid ostium. The subjects were divided into two groups; one with sphenoid sinusitis and the other without sinusitis and all the measurements were evaluated and were compared between groups. RESULTS: The mean length from sphenoid ostium to optic canal were 13.8+/-2.4 mm in control group and 12.9+/-2.2 mm in sinusitis group. The length from sphenoid ostium to carotid artery were 10.4+/-1.5 mm and 10.0+/-1.8 mm in control and sinusitis group, respectively. There were significant differences in both lengths between control and sinusitis group. The bony thickness above and below the ostium were 1.48+/-0.31 mm and 1.73+/-0.27 mm respectively and were significantly different from each other (p<0.001). CONCLUSION: Since the neurovascular structures was relatively distant from the sphenoid ostium and the bony thickness below the ostium was significantly thicker than that above the ostium, the sphenoidotomy removing superolateral side of anterior sphenoid wall could be an alternative procedure, especially, in patients with a thickened bone around sphenoid ostium.
Carotid Arteries ; Humans ; Sinusitis ; Sphenoid Sinus ; Sphenoid Sinusitis

Acute sphenoid sinusitis is a relatively uncommon disease in the post-antibiotic era. Furthermore direct bony destruction and intracranial complications secondary to sphenoid sinusitis are extremely rare. However, it can have a high morbidity and mortality rate. If the diagnosis is delayed, serious problems can occur, so early diagnosis and treatment are required. We represent and discuss a case of cerebrospinal fluid (CSF) rhinorrhea with wide bony destruction directly, secondary to acute sphenoid sinusitis.
Cerebrospinal Fluid Rhinorrhea ; Early Diagnosis ; Sphenoid Sinus ; Sphenoid Sinusitis

Study on adults patients who were multislice computed tomography of craniofacial at the Post and Telecommunication N02 hospital from January to June 2005. In 51 cases there were 22 males and 29 females, age from 22-56 years. 102 sinuses were studied. Results: the diameters of sphenoidal sinus were measured by the greatest diameter with 3 Sagittal Coronol and Axial planes. The general size of sphenoidal sinus: horizontal diameter 1.932 cm, anterio-posterio diameter 2.347 cm, superio-posterio diameter 2.483 cm, superior-inferior diameter 3.156 cm, capacity 3.727 cm3. The technique of multislice computed tomography was the basis and necessary technique not only for diagnosis but also for the base of services in treatment.
Sphenoid Sinusitis ; Tomography ; Tomography, X-Ray Computed

Aspergillus sp. are the most common contaminants found in the paranasal fungal sinusitis, but isolated sphenoid sinus invasion is extremely rare. According to sinus anatomy and depending on its contiguous structures, various symptoms and complications may appear. Of these symptoms and complications, headaches are the most frequently observed in the few documented cases. The treatment is primarily surgical, through either transnasal or transethmoid approach, depending on whether or not the disease is limited to the sphenoid sinus. The transnasal endoscopic technique offers excellent visualization and an atraumatic approach to the sphenoid sinus. It is performed with the superior turbinate used as the key landmark for identification. For this technique, a wide enlargement of the natural sphenoid ostium is also important. Along with a review of literature, we present two cases of sphenoid sinus aspergillosis which were successfully treated by transnasal endoscopic sphenoidotomy.
Aspergillosis* ; Aspergillus ; Headache ; Sinusitis ; Sphenoid Sinus* ; Turbinates

BACKGROUND AND OBJECTIVES: Identification of the natural ostium verifies the safest entry to the sphenoid sinus (SS) in endoscopic sinus surgery (ESS). In order not to destabilize the middle turbinate (MT), new techniques have recently been introduced on transethmoid approaches to the SS ostium after ethmoidectomy. The aims of this study are to introduce an intranasal transethmoid approach to the SS ostium for sphenoidotomy using the superior turbinate (ST) as a key landmark without destabilization of the MT in ESS for chronic sinusitis with concurrent sphenoiditis and to determine its efficacy by evaluating the outcome of the patients. MATERIALS AND METHODS: Fifty-three chronic sinusitis patients (37 males and 16 females, aged 14 to 63 years) with concurrent sphenoiditis in one or both SSs and their 75 SSs were included in this study. Sphenoidotomy was performed in all patients. The SS ostium was identified just medial to the ST remnant. Number of SSs where the ostium was identified was determined, and surgical complications were evaluated. To assess olfactory changes, a butanol threshold test was performed before and after the surgery. RESULTS: The SS ostium was identified in 73 (97.3%) of the 75 SSs. The preoperative threshold (3.9+/-3.0) in the butanol test significantly improved to 5.1+/-2.5 after the operation in the 75 nasal sides. Olfactory function of only 3 (4.0%) sides worsened after surgery. There were no major complications in all patients. Conclusion: This technique may be an effective and safe approach to the SS ostium in ESS for chronic sinusitis with concurrent sphenoiditis without destabilization of the MT.
Female ; Humans ; Male ; Sinusitis ; Sphenoid Sinus* ; Turbinates*

Objective: To present a unique case of blindness resulting from fungal rhinosinusitis involving multiple sinuses mimicking a malignant process in a pregnant patient. Methods: Design: Case Report Setting: Tertiary Government Training Hospital Patient: One Result: A 36-year-old pregnant woman developed unilateral blindness during her 20th week of gestation with a history of binocular diplopia, unilateral nasal obstruction and anosmia for 13 months during the pre-pregnancy period. Sphenoid sinus malignancy was suspected on imaging. The planned biopsy was intraoperatively shifted to endoscopic sinus surgery when clay-like materials were seen involving the left maxillary sinus and bilateral sphenoid and ethmoid sinuses. Histopathologic examination confirmed fungal growth. Postoperatively, nasal symptoms resolved but blindness of the left eye and blurring of vision of the right eye persisted. Conclusion: Fungal rhinosinusitis rarely occurs in multiple sinuses and is commonly misdiagnosed. It can afflict pregnant patients and mimic a malignant process. A high index of suspicion early on, especially in the presence of nasal congestion and diplopia may prevent potentially irreversible complications.
sinusitis ; sphenoid sinus ; maxillary sinus ; pregnancy

Cavernous sinus thrombophlebitis may occur as a complication of infectious and noninfectious processes. Septic thrombosis of the cavernous sinuses is a serious life threatening condition, and most commonly follows midfacial skin infections due to Staphylococcus aureus. Isolated sphenoid sinusitis is a rare and elusive clinical problem, and it is an uncommon cause of cavernous sinus thrombosis. We report a case of cavernous sinus thrombophlebitis of spheoid sinusitis origin. A good result has been achieved with immediate medical measures and surgical drainage.
Cavernous Sinus Thrombosis* ; Cavernous Sinus* ; Drainage ; Sinusitis ; Skin ; Sphenoid Sinus* ; Sphenoid Sinusitis* ; Staphylococcus aureus ; Thrombophlebitis ; Thrombosis

Few have reported fungal sinusitis confined in only sphenoidal sinus which caused orbital complication. Reportedly, early surgical treatment can lead to visual recovery especially in its involvement of optic nerve. We report a patients who was hospitalized due to sudden decrease in visual acuity and headache, and was histopathologically diagnosed as having aspergillosis confined in sphenoid sinus, but failed to show restoration of visual acuity after the operation using nasal endoscope.
Aspergillosis ; Endoscopes ; Headache ; Humans ; Optic Nerve* ; Orbit ; Sinusitis ; Sphenoid Sinus ; Sphenoid Sinusitis* ; Visual Acuity

Isolated sphenoid sinusitis is a rare disorder. There are some difficulties in its diagnosis; therefore the first presentation of this disorder might be with complications. These complications are essentially due to the anatomical location of the sinus and its proximity to the intra-cranial and orbital contents, to which infection may easily spread. A case of isolated sphenoid fungal sinusitis with unilateral abducent nerve palsy is being reported which was successfully treated by parenteral antibiotic therapy and endonasal endoscopic sphenoidotomy.
Abducens Nerve Diseases* ; Abducens Nerve* ; Diagnosis ; Orbit ; Paralysis ; Sinusitis* ; Sphenoid Sinus ; Sphenoid Sinusitis

BACKGROUND AND OBJECTIVES: Isolated sphenoid sinus disease is rare and difficult to diagnosis. Due to the close proximity of the sphenoid sinus to important structures, serious complications can develop. The aim of this study is to evaluate the clinical characteristics of isolated sphenoid sinusitis. SUBJECTS AND METHOD: Thirty-four patients with isolated sphenoid sinusitis were analyzed. A retrospective chart review was performed with respect to the symptoms, radiologic findings, treatment outcomes, and complications. RESULTS: Twenty-one of 34 cases were bacterial sphenoid sinusitis, and 13 cases were fungal sinusitis. Headache was the most common symptom (76.9%), followed by visual disturbance and diplopia. Endoscopic sphenoidotomy was performed, and symptoms completely improved in 88.5% of the patients. CONCLUSIONS: Inflammatory diseases commonly involve the sphenoid sinus, but the presenting symptoms can be nonspecific. Early diagnosis and endoscopic surgical treatment can be successfully employed to treat the majority of patients with isolated sphenoid sinusitis.
Diplopia ; Early Diagnosis ; Headache ; Humans ; Retrospective Studies ; Sinusitis ; Sphenoid Sinus ; Sphenoid Sinusitis