The clinical features of endoscopic treated isolated sphenoid sinus diseases
Journal
Journal of the Formosan Medical Association
Journal Volume
120
Journal Issue
8
Pages
1554-1562
Date Issued
2021
Author(s)
Abstract
Background: Isolated sphenoid sinus disease (ISSD) is a rare clinical entity with potentially serious complications. The etiological distribution of ISSD varies among different areas and ethnicities. We aimed to investigate the clinical features of patients with endoscopic treated ISSD. Methods: We retrospectively reviewed all patients with ISSD who had undergone endoscopic surgery between April 2013 and May 2019. The patient records were reviewed for demographic data, clinical presentations, endoscopic and imaging study findings, surgical outcomes and complications. Results: A total of 37 patients with ISSD who underwent surgery were recruited. We divided patients into three groups according to etiology, including inflammatory diseases (78.4%), neoplasms (13.5%) and spontaneous cerebrospinal fluid (CSF) leaks (8.1%); fungal ball (62.2%) constituted the major cause of ISSD. Overall, the most common presenting symptom was headache or facial pain (65.5%). The endoscopic findings of bloody discharge and tumor lesions were mainly from the neoplasm group. Bony defects were more obvious on computed tomography in the neoplasm and CSF leak groups. Magnetic resonance imaging revealed a higher rate of involvement of the cavernous sinus (40.0%) and intracranial extensions (40.0%) in the neoplasm group. To summarize the surgical outcomes, the success rate was 97.1%, and the major complication rate was 5.4%. Conclusion: ISSD represents a variety of etiologies, mostly comprising fungal ball in our area, while there is still a considerable proportion of ISSDs attributed to neoplasm and CSF leak. Untreated ISSD can result in serious complications. We recommend early surgical intervention for all patients with ISSD. ? 2020
Subjects
Cerebrospinal fluid leak; Fungal infection; Sinonasal neoplasm; Sinusitis; Sphenoid sinus
SDGs
Other Subjects
adrenalin plus lidocaine; adult; aged; Article; cavernous sinus; chronic rhinosinusitis; clinical article; clinical feature; computer assisted tomography; controlled study; encephalomeningocele; endoscopic sinus surgery; face pain; female; fungus ball; hamartoma; head and neck squamous cell carcinoma; headache; human; hypophysis adenoma; inverted papilloma; liquorrhea; male; meningocele; mucocele; nose polyp; nuclear magnetic resonance imaging; paranasal sinus carcinoma; paranasal sinus disease; paranasal sinus tumor; paranasal sinusitis; postoperative complication; retrospective study; sphenoid sinus; Taiwan; diagnostic imaging; endoscopy; x-ray computed tomography; Endoscopy; Humans; Paranasal Sinus Diseases; Retrospective Studies; Sphenoid Sinus; Tomography, X-Ray Computed
Publisher
Elsevier B.V.
Type
journal article