The clinical behavior of isolated sphenoid sinusitis

Abstract

We sought to study the clinical behavior and treatment outcome of isolated sphenoid sinusitis (ISS). We conducted a retrospective study of patients diagnosed with ISS in a tertiary medical center over 20 years. Of 72 patients with ISS, 79 percent had acute symptoms, 15 percent had chronic symptoms, and 6 percent had incidental radiological findings. Fifteen percent were children. Most patients were diagnosed between January and April (P < 0.01), and increasing incidence was noted over the years (P < 0.001). Headache was the most common presenting symptom (85%). Chronic patients complained also of nasal symptoms (82%). Six patients had a major complication of sinusitis (none of them were children), and two patients died. Immunocompromised patients had more major complications (P <or= 0.001) and increased mortality (P <or= 0.01). Most patients need conservative treatment alone. However, life-threatening complications are not infrequent. Close observation and early surgical intervention, if needed, provide the mainstay of treatment. This is the first large series that focuses on the clinical behavior, complications, and treatment of ISS.