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Isolated sphenoid sinusitis after transsphenoidal hypophysectomy.

Pete S Batra1, Martin J Citardi, Donald C Lanza

  • 1Department of Otolaryngology and Communicative Disorders, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.

American Journal of Rhinology
|June 1, 2005
PubMed
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Post-transsphenoidal hypophysectomy, 7.5% of patients developed sinusitis, often isolated sphenoid sinusitis. Early diagnosis and aggressive treatment are crucial for resolving symptoms.

Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Infectious Disease

Background:

  • Incidence and management of sinusitis following transsphenoidal hypophysectomy are not well-documented.
  • Transsphenoidal hypophysectomy is a surgical procedure to remove the pituitary gland.

Observation:

  • A retrospective analysis of 200 patients undergoing transsphenoidal procedures was performed.
  • Postoperative sinusitis developed in 7.5% of patients.
  • Most cases presented as isolated sphenoid sinusitis with nonspecific symptoms like headaches and nasal discharge.

Findings:

  • Nine out of ten patients with sinusitis had isolated sphenoid sinusitis.
  • Medical management resolved symptoms in 50% of cases.
  • Endoscopic sphenoidotomy was required for refractory disease, with successful resolution in all treated patients.

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  • Intraoperative findings included fungal balls, mucocele, and infected fat grafts.

    • Implications:

    • A high index of suspicion is necessary for diagnosing isolated sphenoid sinusitis post-transsphenoidal hypophysectomy.
    • Prompt and aggressive medical or surgical intervention is essential for managing refractory symptoms.
    • This study highlights the importance of multidisciplinary care involving otorhinolaryngology.