Abstract
Solitary or isolated involvement of the sphenoid sinus (Isolated sphenoid sinus disease; ISSD ) is a relatively uncommon disease. The present study reviews retrospectively 125 patients with ISSD treated at the Departments of Otolaryngology, Eye Ear Nose and Throat Hospital, Shanghai Medical University (109), and Hyogo College of Medicine (16) over a period of 25 years. Diagnosis was made on the basis of history, signs, nasal endoscopy, imaging techniques with CT/MRI. The final diagnosis of ISSD was established after histopathological and microbiological examinations of the excisional specimen. The pathology was sphenoid sinusitis (40), sphenoid cysts (35), fungal diseases (19), malignant tumors (9), and others (20). The most common initial symptom was headache, followed by visual changes and cranial nerve palsies due to the nearby involvements. Increasing use of routine imaging techniques with CT/MRI and diagnostic nasal endoscopy resulted in the increased numbers of early ISSD. Recent nasal endoscopic ostial sphenoidotomy warrants for the precise pathological diagnosis, and at the same time for the safe and immediate treatment, prior to the sequential extension to adjacent vital structures even to the serious or fatal stage.
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