The clinical behavior of isolated sphenoid sinusitis

OBJECTIVE: We sought to study the clinical behavior and treatment outcome of isolated sphenoid sinusitis (ISS). STUDY DESIGN AND SETTING: We conducted a retrospective study of patients diagnosed with ISS in a tertiary medical center over 20 years. RESULTS: 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 <= 0.001) and increased mortality (P <= 0.01). CONCLUSION: 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. SIGNIFICANCE: This is the first large series that focuses on the clinical behavior, complications, and treatment of ISS. (C) 2007 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.