Air-fluid levels in the sphenoid sinus in epistaxis and nasal packing

Air-fluid levels in the sphenoid sinus have been described in association with skull fracture, cerebrospinal fluid rhinorrhea, and sinusitis. The authors have observed this sign in the absence of significant trauma in patients with epistaxis and nasal packing. The fluid is probably normal sinus secretion retained due to prolonged recumbency, although other explanations for its accumulation are discussed.