Metin YILMAZ, Yusuf KIZIL, Fikret İLERI, Süleyman Sabri USLU, Mehmet GÖCEK, Fakih Cihat ERAVCI, Alper CEYLAN

Isolated sphenoid sinus pathologies: a series of 40 cases

Background/aim: Isolated sphenoid sinus-derived lesions are rare and generally present with unclear symptoms. We are sharing our experience to be mindful of such lesions in differential diagnosis and to help accomplish successful treatment while avoiding revisions and complications. Materials and methods: Data from patients who underwent isolated sphenoid sinus surgeries (ISSs) were retrospectively extracted from the period of January 2005 to August 2015. Demographic data, chief complaints and presenting symptoms, imaging findings, surgical management, and results were evaluated. Results: There were 40 patients who underwent ISS. These patients had different pathologies. The chief complaint was nonspecific headache, except for cerebrospinal fluid leak patients who presented with serous rhinorrhea. Conclusion: It is critical to investigate suspicious symptoms with clinical findings and imaging techniques to avoid late diagnoses of isolated sphenoid pathologies. The transnasal approach is more minimally invasive and tissue-sparing. In our experience, we have noted that excising the inferior one-third of the superior turbinate decreases revisions. On the other hand, results show that the presence of concomitant pathology and invasive fungal disease increases the risk of revision surgery and complications.

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1. Marcolini TR, Safraider MC, Socher JA, Lucena GO. Differential diagnosis and treatment of isolated pathologies of the sphenoid sinus: retrospective study of 46 cases. Int Arch Otorhinolaryngol 2015; 19: 124-129.
2. Sieskiewicz A, Lyson T, Olszewska E, Chlabicz M, Buonamassa S, Rogowski M. Isolated sphenoid sinus pathologies--the problem of delayed diagnosis. Med Sci Monit 2011; 17: CR180- 184.
3. Manjula BV, Nair AB, Balasubramanyam AM, Tandon S, Nayar RC. Isolated sphenoid sinus disease - a retrospective analysis. Indian J Otolaryngol Head Neck Surg 2010; 62: 69-74.
4. Socher JA, Cassano M, Filheiro CA, Cassano P, Felippu A. Diagnosis and treatment of isolated sphenoid sinus disease: a review of 109 cases. Acta Otolaryngol 2008; 128: 1004-1010.
5. Psaltis AJ, Schlosser RJ, Banks CA, Yawn J, Soler ZM. A systematic review of the endoscopic repair of cerebrospinal fluid leaks. Otolaryngol Head Neck Surg 2012; 147: 196-203.
6. Burke MC, Taheri R, Bhojwani R, Singh A. A practical approach to the imaging interpretation of sphenoid sinus pathology. Curr Probl Diagn Radiol 2015; 44: 360-370.
7. Karkas A, Rtail R, Reyt E, Timi N, Righini CA. Sphenoid sinus fungus ball. Eur Arch Otorhinolaryngol 2013; 270: 893-898.
8. Thery A, Espitalier F, Cassagnau E, Durand N, Malard O. Clinical features and outcome of sphenoid sinus aspergillosis: a retrospective series of 15 cases. Eur Ann Otorhinolaryngol Head Neck Dis 2012; 129: 179-184.
9. Bansal S, Grover G, Grover M, Gupta AK. Isolated sphenoid mucormycosis presenting as visual impairment: changing trends? Am J Otolaryngol 2010; 31: 64-66.
10. Melo NA, Borges BB, Magliarelli Filho PA, Godoy MD, Pereira LV, de Rezende Pinna F, Voegels RL. Lateral sphenoid sinus recess cerebrospinal fluid leak: a case series. Eur Arch Otorhinolaryngol 2014; 271: 2587-2594.
11. Ozdemir S, Tarkan O, Tuncer U, Surmelioglu O, Dogrusoz M, Ergin M. A case of extramedullary plasmacytoma in the sphenoid sinus with unilateral loss of vision. J Craniomaxillofac Surg 2013; 41: 140-143.
12. Tsukahara K, Nakamura K, Motohashi R, Endo M, Sato H. A case report of malignant melanoma of the sphenoid sinus. Case Rep Otolaryngol 2013; 2013: 613472.
13. Petersson F, Hui TS, Loke D, Putti TC. Metastasis of occult prostatic carcinoma to the sphenoid sinus: report of a rare case and a review of the literature. Head Neck Pathol 2012; 6: 258- 263.
14. Shobha BV, Shivakumar BN, Reddy S, Dutta N. Sinonasal hemangiopericytoma: a rare case report with review of literature. J Oral Maxillofac Pathol 2015; 19: 107.
15. Terada T. Renal cell carcinoma metastatic to the nasal cavity. Int J Clin Exp Pathol 2012; 5: 588-591.