Acute Sphenoid Sinusitis Research Articles

Status Epilepticus with Fever in a Toddler with Pyogenic Meningitis Due to Complicated Acute Sphenoid Sinusitis

We present a toddler with acute sphenoid sinusitis presenting as status epilepticus with fever, intracranial abscess and meningitis. Cerebrospinal fluid (CSF) analysis suggested bacterial meningitis, but polymerase chain reaction (PCR) test was positive for human herpes virus-6 (HHV-6). We highlight diagnosis and treatment of this uncommon condition.

Somnolence in a pediatric acute sphenoid sinusitis case.

Pediatrics InternationalAccepted Articles e15312 Clinical Note Somnolence in a pediatric acute sphenoid sinusitis case Masazumi Miyahara, Corresponding Author Masazumi Miyahara masazumi.m@k6.dion.ne.jp orcid.org/0000-0003-4855-1787 Department of Pediatrics, Okanami General Hospital, 1734 Uenokuwamachi, 518-0842, Iga, Mie, JapanCorrespondence: Masazumi Miyahara, M.D, Department of Pediatrics, Okanami General Hospital, 1734 Uenokuwamachi, Iga, Mie 518-0842, Japan, Phone number: +81-595-21-3135, Fax number: +81-595-21-5237. Email: masazumi.m@k6.dion.ne.jpSearch for more papers by this authorKyoko Osaki, Kyoko Osaki Department of Pediatrics, Okanami General Hospital, 1734 Uenokuwamachi, 518-0842, Iga, Mie, JapanSearch for more papers by this author Masazumi Miyahara, Corresponding Author Masazumi Miyahara masazumi.m@k6.dion.ne.jp orcid.org/0000-0003-4855-1787 Department of Pediatrics, Okanami General Hospital, 1734 Uenokuwamachi, 518-0842, Iga, Mie, JapanCorrespondence: Masazumi Miyahara, M.D, Department of Pediatrics, Okanami General Hospital, 1734 Uenokuwamachi, Iga, Mie 518-0842, Japan, Phone number: +81-595-21-3135, Fax number: +81-595-21-5237. Email: masazumi.m@k6.dion.ne.jpSearch for more papers by this authorKyoko Osaki, Kyoko Osaki Department of Pediatrics, Okanami General Hospital, 1734 Uenokuwamachi, 518-0842, Iga, Mie, JapanSearch for more papers by this author First published: 27 July 2022 https://doi.org/10.1111/ped.15312 This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/ped.15312 AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Accepted ArticlesAccepted, unedited articles published online and citable. The final edited and typeset version of record will appear in the future.e15312 RelatedInformation

Surgical Management of Acute Sphenoid Sinusitis: A Review

Sphenoidal sinusitis is usually described as acute inflammation of the sphenoid sinuses - either one or both - (the two large cavities just behind the nose and between the eyes). The disease is relatively uncommon—comparatively, chronic sphenoid sinusitis is more common—and may be limited to the sphenoid sinus or, more commonly, may involve multiple sinuses or pansinusitis. Acute sphenoid sinusitis can lead to symptoms such as headaches, nausea, and even complications in the orbit. For low vision, early diagnosis and treatment is essential to preserve vision and life. This study aims Learn about surgical approaches to the treatment of acute sinusitis

Acute isolated sphenoid sinusitis in children: A case series and systematic review of the literature

ObjectiveThis study aims to present a case series and systematic review of acute isolated sphenoid sinusitis (AISS) in children in order to better characterize clinical presentation, diagnosis, treatment, and outcomes of this condition. Data sourcesOvid MEDLINE, Pubmed, Embase, Cochrane Library, and Google Scholar. Study selectionPreferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Full-text, peer-reviewed journal publications from 1994 to 2020 in English; focus on acute sphenoid sinusitis; pediatric patients (<18 years of age); series with two or more children. Studies were assessed for data including demographics, presenting symptoms and signs, radiological investigations, treatment, outcomes and complications. ResultsTen studies identifying 71 patients were included. Average age at presentation was 12.0 years (range 5–17 years). M:F ratio 1:1. The most common presenting symptoms were headache (98.6%), fever (50.7%), nasal symptoms (22.5%) ocular symptoms (19.7%) and decreased level of consciousness (12.7%). Twenty patients (28.1%) had neurological signs. Twenty-three patients (32.4%) presented with headache in isolation. Unsuspected diagnosis at presentation was noted in 54.0%. Average time to initial presentation was 14.0 days (median = 5.5 days, range 1–90 days). The majority of children were treated with antibiotics (98.6%) with 31.0%, 2.8% and 2.8% also undergoing sinus surgery, revision sinus surgery and neurosurgery, respectively. Intracranial complications occurred in 16.9% of patients. Significant long term sequelae occurred in 2 children (2.8%) and one death (1.4%) was also reported. LimitationsAll studies were retrospective case note reviews. ConclusionsAcute sphenoid sinusitis is a rare and difficult condition to diagnose in children. The majority of patients make a full recovery with appropriate treatment. If treatment is delayed however consequences can be life-threatening.

A FROSTY CASE OF FACIAL FROSTBITE IN THE FACE OF LIQUID OXYGEN

SESSION TITLE: Medical Student/Resident Respiratory Care SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Long-term oxygen therapy (LTOT) is used by more than 1.5 million US adults and has been shown to both decrease mortality and increase quality of life in hypoxemic COPD. Many mechanical injuries involving LTOT are user directed and occur when a heat source ignites purified oxygen (O2), such as cigarettes. Here, we report the first English case of frostbite injury to the face due a malfunctioning liquid oxygen (LOx) canister. CASE PRESENTATION: Our patient was an 80-year-old female with a significant past medical history of COPD who presented to the emergency room with epistaxis and mucopurulent rhinorrhea after her nasal cannula (NC) was found frozen to her face. It was reported that LOx traveled up her NC. On physical exam, she had multiple second and third-degree burns on her nose, throat, lips, cheeks, and neck. She was placed on an open non-rebreather mask, and her facial frostbite was empirically treated with vancomycin and ampicillin-sulbactam for fourteen days to prevent cavernous sinus thrombosis. Otolaryngology was consulted to debride her wounds and open her nasal passages. A PEG tube was required to maintain her nutritional status. Towards the end of her fourteen-day hospital stay, her burns had shrunk and become more demarcated. However, the patient became febrile and complained of a painful headache. A CT of her head revealed acute sphenoid sinusitis, for which she was discharged on amoxicillin-clavulanic acid and doxycycline for an additional seven days. DISCUSSION: A cryogenic LOx tank consists of two vessels: an inner chamber where the LOx is kept cool by an insulated area around it from which air is removed, and an outer chamber which consists of a vaporizer that converts LOx into a gaseous state [1]. O2 is cooled to less than -183°C to achieve its liquid form for storage and transportation efficiency [1], as one liter of LOx offers 860 liters of gaseous O2. This large liquid-to-gas expansion ratio can generate an enormous amount of pressure. One case study describing frostbite injury due to a compressed gaseous O2 tank postulated that it was caused by pressure regulation failure, and showed that increasing amounts of pressure led to a significant decrease in temperature of the compressed air [1]. Similarly, we believe that our patient’s LOx pressure release system malfunctioned, driving a large outflow of unconverted LOx to penetrate the vapor chamber, enter her NC, and freeze her face. Unlike typical frostbite, burns involving LOx occur over seconds and are more likely to infiltrate underlying tissue compared to thermal burns. Removal of the LOx and rewarming as soon as possible should be done to prevent further damage [2]. CONCLUSIONS: The broad utilization of LTOT can invite extremely rare cases of hardware malfunction that may cause severe injury. Safety protocols and schedules should be strictly followed for refilling and handling O2 storage equipment. Reference #1: Jabbour, N., Heman-Ackah, S. E., Day, A. T., & Odland, R. (2011). Severe nasal frostbite injury from nasal cannula supplemental oxygen malfunction. American Journal of Otolaryngology, 32(4), 349–352. doi:10.1016/j.amjoto.2010.03.009 Reference #2: Uygur, F., Sever, C., & Noyan, N. (2009). Frostbite Burns Caused by Liquid Oxygen. Journal of Burn Care & Research, 30(2), 358–361. doi:10.1097/bcr.0b013e318198a769 DISCLOSURES: No relevant relationships by Olson Knight, source=Web Response No relevant relationships by munir shah, source=Web Response No relevant relationships by Parth Shah, source=Web Response No relevant relationships by Krupa Solanki, source=Web Response

Clival Bone Marrow Edema Secondary to Acute Sphenoid Sinusitis: A Case Report

Clival Bone Marrow Edema Secondary to Acute Sphenoid Sinusitis: A Case Report

Sinus Balloon Dilation as Treatment for Acute Sphenoid Sinusitis with Impaired Vision for a Child.

This paper is about sinus balloon dilatation in treatment of acute left sphenoid sinusitis with left impaired vision in a child. Balloon catheter dilatation (BCD) of the sinus ostia is a new technique. It has been shown to be a minimally invasive technique to manage chronic sinusitis. However, this method is rarely used in the treatment of acute sinusitis. So far, we know of no reported cases of sinus balloon dilatation in treatment of this case, especially for children.

Bilateral Blindness Due to Acute Isolated Sphenoid Sinusitis- Is It Reversible? A Case Report

Acute isolated sphenoid sinusitis is a rare and is seen in only 3% of all cases of all sinusitis. It is frequently misdiagnosed because of its vague clinical presentation. We report a case of 35year old female who presented to our emergency department with complaints of painless rapidly developing bilateral vision loss. Non contrast computed tomography of paranasal sinuses showed only mild opacification of sphenoid sinus. Endoscopic sphenoidectomy was performed within 4 hrs of presentation. After 48 hrs of surgery the patient vision returned to 6/6 bilaterally. Acute sphenoid sinusitis should be considered in the differential diagnosis of acute vision loss. Awareness, early diagnosis, astute clinical sense and emergent intervention can prevent permanent complication.DOI: http://dx.doi.org/10.3329/jom.v15i2.20700 J MEDICINE 2014; 15 : 146-148

An intracranial complication of acute isolated sphenoid sinusitis

Intracranial complications of acute sphenoid sinusitis are a rare, but severe condition. Due to subclinical and non-specific symptomatology it is usually diagnosed with delay or after neurological manifestation is present. A case of temporal epidural abscess secondary to isolated sphenoid sinusitis in a 14-year-old boy is presented. Immediate endoscopic sinus surgery was performed. Early diagnosis and aggressive therapy to guarantee drainage of the sinus is recommended.

Acute sphenoid sinusitis leading to contralateral cavernous sinus thrombosis: a case report

The objective of this article was to report a case of isolated, acute, right-sided sphenoid sinusitis that progressed to contralateral cavernous sinus thrombosis in an 18-year-old male patient. We describe the atypical presentation of this case and discuss the relevant anatomy, pathogenesis, presentation, diagnostic evaluation and treatment. A case report of sphenoid sinusitis leading to contralateral cavernous sinus thrombosis was reviewed and presented along with a comprehensive literature review of the relevant anatomy, pathophysiology, microbiology, diagnostic work-up and treatment options. Cavernous sinus thrombosis is a rare clinical entity in the antibiotic era. However, limited sphenoid sinusitis may progress to cavernous sinus thrombosis in spite of maximal medical treatment, as highlighted in this case report. The mainstay of treatment includes early diagnosis allowing aggressive intravenous antibiotics and appropriate surgical management.

Lemierre Syndrome: Thrombosis of the Cavernous Sinus and Internal Carotid Artery Occlusion Secondary to Acute Sphenoid Sinusitis

Lemierre syndrome typically consists of a septic thrombophlebitis of the internal jugular vein caused by Fusobacterium necrophorum. We present an unusual variant of Lemierre syndrome with cavernous sinus thrombosis and occlusion of the ipsilateral internal carotid artery secondary to sphenoid sinusitis caused by Streptococcus viridans.

Ostre izolowane zapalenie zatoki klinowej – opis 4 przypadków

IntroductionIsolated acute sphenoid sinusitis is an uncommon sinus infection, frequently misdiagnosed and not usually considered in the differential diagnosis of acute severe headache, with the potential of serious neurologic complications. AimDescribe four patients with acute sphenoid sinusitis who presented with acute onset of severe headache and consider the role of medical or surgical management. Two patients do not required surgical intervention and medical treatment was sufficient. One patient had sphenoidotomy due to meningitis. One patient was performed surgical intervention after fail of medical therapy. Acute isolated sphenoid sinusitis appears to be difficult to diagnose. It is important to be aware of acute sphenoid sinusitis in the setting of new onset severe headache, when imaging studies are unrevealing for intracranial pathology. Medical therapy focused on infection, inflammation, and obstruction may be adequate for resolution, but surgical intervention may be required in certain situations.

Neurological symptoms in children caused by isolated sphenoid sinusitis

Isolated sphenoid sinusitis in children presents with a broad spectrum of neurological symptoms. As a consequence, orbital and intracranial complications can occur because of the proximity to the eyes and brain. Our patient was admitted to the hospital due to occipital headache that started two weeks before and meningism in the absence of fever. Blood tests and funduscopy were normal. Magnetic resonance scan revealed isolated left sphenoid sinusitis. Centrotemporal focal slowing was recorded on electroencephalogram. After a few days of antibiotic therapy, all symptoms disappeared. Electroencephalographic focal changes vanished within a month. Acute sphenoid sinusitis is a potentially devastating, but curable condition. It should be considered in differential diagnosis of headache and other unclear neurological symptoms.

Miller fisher variant of guillain‐barré syndrome masquerading as acute sphenoid sinusitis with orbital apex syndrome

Miller Fisher syndrome (MFS), a variant of Guillain-Barré syndrome, is a rare disorder typically characterized by a triad of ataxia, areflexia, and ophthalmoplegia, which may have a highly variable clinical presentation. We report a case of MFS in a 45-year-old female presenting with sphenoid sinusitis and sixth nerve palsy. She underwent endoscopic sphenoid sinusotomy without improvement, had postoperative deterioration, was diagnosed with MFS, and was treated with intravenous immunoglobulin with complete response. Because of the potential severity of Guillain-Barré syndrome, great vigilance should be taken when examining sixth nerve palsies to prevent misdiagnosis and delay in treatment of the MFS variant of this disease.

Acute Sphenoid Sinusitis Induced Blindness: A Case Report

BackgroundAcute, isolated sphenoid sinusitis is a rare but potentially devastating clinical entity. Missing this diagnosis can lead to permanent vision loss due to injury of the optic nerve. Patients may present with preseptal inflammation, lid edema, chemosis, or ophthalmoplegia. ObjectiveWe report a case of acute sphenoid sinusitis in a 10-year-old child who presented to the Emergency Department with essentially painless vision loss. Case ReportPreviously healthy, the patient reported progressive decrease in vision in her right eye for the 5 days prior. Other than blurred vision in the right eye, she complained of a mild frontal headache and right eye irritation the past week, which had abated. On examination, she was reading a book with her head tilted to one side. She had no photophobia, or facial or eyelid swelling. Her pupils were 5 mm bilaterally, but the right was non-reactive to light. She was unable to see two fingers 6 inches in front of her face (right eye), whereas her visual acuity on the left was 20/25. She had bilateral elevated intraocular pressures and a Marcus Gunn pupil on the right. Ophthalmology was consulted and the diagnosis of acute sphenoid sinusitis causing compression and vascular compromise to the optic nerve was diagnosed ultimately by magnetic resonance imaging. The patient was transferred to the nearest pediatric specialty hospital, where an emergent endoscopic sphenoidotomy was performed. The patient’s vision subsequently returned. ConclusionSphenoid sinusitis should be considered in patients presenting with acute vision loss. Awareness, early diagnosis, and intervention help prevent permanent complications.

Coexistent Optic Neuritis and Isolated Acute Sphenoid Sinusitis

Abstract We report two cases of optic neuritis associated with isolated acute sphenoid sinusitis. This is the first report of isolated sphenoid sinusitis with dehiscent optic canal with exposed nerve presented with optic neuritis without any orbital inflammation. In both cases visual acuity deteriorated with steroid therapy, CT scan showed air fluid in the sphenoid sinus with dehiscent optic canal. Antibiotic, sphenoidotomy and later steroid course had a partial recovery in vision.

Sinus headaches: avoiding over- and mis-diagnosis

‘Sinus headache’ is a term used by many patients and primary-care physicians and, contrary to popular belief, sinus headaches are uncommon. Headaches that are due to sinusitis are confined to a minority of patients who have acute frontal sinusitis or sphenoiditis. The International Headache Society classification is robust in qualifying the term sinus headache and says that “chronic sinusitis is not validated as a cause of headache and facial pain unless relapsing into an acute stage”. The vast majority of people who present with a symmetrical frontal or temporal headache, sometimes with an occipital component, have tension-type headache. Unilateral, episodic headaches are often vascular in origin. The idea that sinusitis can trigger migraine is misplaced, as the whole symptom complex is vascular and coexisting nasal congestion is due to vasodilation of the nasal mucosa that is sometimes part of the vascular event. The use of nasal endoscopy and imaging of the paranasal sinuses have advanced our appreciation that these patients are suffering from a vascular event. When these patients are asked to attend a clinic when they are symptomatic, the vast majority are found not to have a sinus infection. Sinusitis rarely causes headache, let alone facial pain, except when there is an acute bacterial infection when the sinus in question cannot drain, and it is usually unilateral due to increased pressure and inflammation caused by pus trapped within the sinus cavity. These patients usually have a history of a viral upper respiratory infection immediately before this and they have pyrexia with unilateral nasal obstruction. The vast majority of patients with acute sinusitis respond to antibiotics. Recurrent bacterial sinusitis is rare and anyone with more than two episodes of genuine bacterial sinusitis in 1 year should be investigated for evidence of poor immunity. Patients with chronic bacterial sinusitis rarely have any pain unless the sinus ostia are blocked and their symptoms are then the same as in acute sinusitis. Within the medical literature, there are texts that report that sphenoid sinusitis can cause headaches and, as with other acute sinus infections, intracranial or ophthalmolgical complications can occur. First, acute sphenoid sinusitis is rare and second, most of these patients respond to antibiotics. Batotrauma can cause short-lived pain in the sinus involved but there is always a clear history associated with diving or flying and, as the pressure within the sinus equalizes, the pain resolves within a few hours. Headaches are rarely due to sinusitis.

Neurological complications with acute sphenoid sinusitis a surgical emergency?

Isolated acute sphenoid sinusitis is an uncommon sinus infection, frequently misdiagnosed and not usually considered in the differential diagnosis of acute severe headache, with the potential of serious neurologic complications. To describe two patients with acute sphenoid sinusitis who presented with acute onset of severe headache and consider the role of surgical management. Case report. Tertiary care hospital. Patient 1 developed right cavernous sinus thrombosis and permanent visual loss in one eye, requiring sphenoidotomy following failure of medical treatment. Patient 2 experienced failure of the medical treatment. However, sphenoidotomy abated all his symptoms without any neurologic sequelae. It is important to be aware of acute sphenoid sinusitis in the setting of new onset severe headache, when imaging studies are unrevealing for intracranial pathology. Considering the serious consequences of failed medical treatment vis-à-vis the safety and efficacy of sphenoidotomy we propose surgical intervention at the time of diagnosis.

Zapalenie zatoki klinowej

Isolated sphenoid sinusitis is being diagnosed quite rare and it is caused by uncharacteristic evidences. Acute sphenoid sinusitis is usually diagnosed when intracranial complications are seen. 11 cases aged 8–74 years hospitalized between 1999–2005 are retrospective analyzed. Diagnosis of isolated sphenoid sinusitis was made after ENT and radiological examination. The most common evidence (10/11 cases) was headache, they last 1 week – 1 year, in 1 case 30 years. Acute inflammation was diagnosed in 2 cases and in all intracranial complication was developed. Meningitis, temporal lobe abscesses, orbital cellulites and paresis of CN VI in case of 11 years old girl and in other case of 37 years old man aseptic meningitis developed. Chronic sinusitis was diagnosed in 6 cases and in other 3 mucocele was present. Progressive atrophy of CN II was the only complain in case of 8 years boy, in rest of cases of chronic sinusitis headache was the only complain. External approach sphenoidotomy in 3 cases and endoscopic approach in 8 cases was managed. Isolated sphenoid sinusitis was usually diagnosed when neurological or ophthalmologic evidences were being evaluated. Surgical treatment is indicated in chronic sinusitis and in cases with no recovery after i.v. antibiotic course or when complication develops. Complications of isolated sphenoid sinusitis often anticipate rynologic evidences that can be absent.

A Case of Optic Neuritis in Acute Sphenoid Sinusitis

Purpose: We encountered a rare case of optic neuritis that developed in a sphenoid sinusitis. This case has not been reported at any of the Korean Ophthalmological Society meetings. Case summary: A 12-year-old boy with swollen optic disc was diagnosed with optic neuritis secondary to sphenoid sinusitis, through orbit MRI (magnetic resonance imaging) and paranasal sinus CT (computed tomography). We observed the recovery of visual acuity and the improvement of papilledema after treatment. In the initial examination, the BCVA (best-corrected visual acuity) of the right eye was only hand movement. Papilledema was detected by ophthalmoscopy. Orbit MRI and paranasal sinus CT were then performed, which revealed that sphenoid sinusitis had invaded the right optic nerve. Treatment included the use of antibiotics, systemic steroid therapy, and endoscopic sinus surgery. One month after treatment, the BCVA of the right eye was 1.0 and the papilla of right eye had a normal ophthalmoscopic finding. Conclusions: Sphenoid sinusitis can be a cause of optic neuritis. The treatment of optic neuritis caused by paranasal sinusitis must include antibiotics use or endoscopic sinus surgery to remove the sinus inflammation as well as high dose steroid therapy.