Endoscopic surgical treatment of patients with isolated sphenoid sinus disease – the literature review based on 15 rare cases
Paweł Stręk, Olaf Zagólski, Karolina Hydzik-Sobocińska, Jacek Składzień
CaseRepClinPractRev 2004; 5:551-555
Background: Cases of isolated lesions of the sphenoid sinus are rare. For descriptive purposes, clinicians divide them into inflammatory and non-inflammatory with prevalence of the former. Symptoms of the sphenoid sinus disease are difficult to characterise, the most common of them being vague headache and visual disturbances. Thorough preoperative evaluation of the lesion is essential - nasal endoscopy must be performed and computerised tomography or magnetic resonance imaging results analysed. Case Report: The purpose of the study is to present the assessment of endoscopic surgery outcome in the own group of patients with isolated sphenoid disease, with particular emphasis on very rare lesions - sphenoid osteoma and inverted papilloma, based on review of the literature. Clinical data of 15 subjects were analysed retrospectively. There were 6 patients with bacterial sinusitis, 4 with fungal sinusitis, 3 with allergic thickening of the mucous membrane with no evidence of bacterial or fungal infection, 1 with sphenoid osteoma and 1 with inverted papilloma. Each patient had preoperative nasal endoscopy and CT/MRI imaging performed. Then they underwent endoscopic transnasal sphenoidotomy with removal of the lesion. The sphenoid sinus was approached through its front wall. The patients’ postoperative course was uneventful. They noted improvement in all preoperative symptoms, except for bilateral oculomotor nerve paralysis in one individual, and were asymptomatic to ophthalmological examination.Conclusions: Isolated lesions of the sphenoid sinus, even very rare tumours like those presented here, can be in most cases safely approached and removed endoscopically. All risks of the method must be considered prior to the operation.
Keywords: Paranasal Sinuses, Sphenoid Sinus, endoscopic sinus surgery