Isolated Sphenoid Sinus Disease: Analysis of 11 Cases

Objective: To evaluate the presenting symptoms, imaging data, surgical treatment, and clinical outcomes associated with isolated sphenoid sinus disease. Patients and Methods: From July 2003 to February 2008, the authors performed surgery on 11 patients with isolated sphenoid sinus diseases. The presenting signs and symptoms, radiological studies, operative findings, and clinical outcomes were retrospectively reviewed and analyzed. Results: Five patients presented with a fungal process, three with sphenoid sinusitis, one with mucocele, one with an angiofibroma, and one with fibrous dysplasia. The most common presenting symptom was headache, followed by rhinorrhea and visual symptoms. Ten patients were treated endoscopically and one patient was treated with an external approach. Conclusion: Because of the proximity of the sphenoid sinus to important and vulnerable structures of the skull base, delay in diagnosis and treatment can lead to the development of serious intracranial and orbital complications. The presenting symptoms of patients with an isolated sphenoid sinus lesion are often vague and nonspecific, with headache being the only reliable finding. Endoscopic sinus surgery is a safe, effective, and direct approach to the sphenoid sinus.