Unusual presentations of isolated sphenoid sinus lesions

ABSTRACT

Isolated sphenoid sinus disease is a rare and often-difficult condition to diagnose. In this series, 44 patients have isolated sphenoid sinus opacification on C. T scan. It is more common in female [59.1%]. There are often vague and non-specific presentations. The main clinical presentation was unresolving headache varied from the typical sinus headache [72.7%]. Diplopa is the only symptoms in [15.9%] of cases. Partial 3rd and 6th nerve palsy in [13.6%] of cases. The main predisposing factors were diabetes mellitus [88.6%] and patients on long term orticosteroids [6.5%]. Fungal sphenoid sinusitis was present in about [90.9%] of cases. MRI was indicated when C. T scan demonstrates erosions and de hiscence [15.90%]. transnasal microscopic assisted endoscopic approach with partial resection of the posterior end of the middle turbinate was the operation of choices. Intra operative dehiscence over the carotid was present in about [27.3%]