ABSTRACT
<p><b>OBJECTIVE</b>To investigate the relationship of sphenoid disease and orbital apex syndrome and to improve the diagnosis of sphenoid disease.</p><p><b>METHODS</b>Twelve patients with sphenoid disease manifesting orbital apex syndrome from 2000 to 2004 were retrospectively analyzed, especially the processes of both diagnosis and treatment. The factors which may lead to misdiagnosis were discussed.</p><p><b>RESULTS</b>All the twelve patients failed to be correctly diagnosed at the ophthalmology department. Having been undergone CT or MRI, seven cases of sphenoiditis, three cases of polyps of sphenoidal sinus and two cases of sphenethmoid mucocele were confirmed respectively. All of the patients underwent endoscopic sphenoid surgery. The symptoms of the patients were improved or disappeared after the operations.</p><p><b>CONCLUSIONS</b>The sphenoid disease with orbital apex syndrome was easily misdiagnosed. The possible causes of misdiagnosis were: low incidence of the disease, nonspecific eye symptoms, and unawareness of the doctor, especially ophthalmologist. CT or MRI are the gold standards of diagnosis of sphenoid disease. Endoscopic sinus surgery is effective and safe technique for the treatment of the disease.</p>