[Isolated sphenoid sinus lesions: a clinical analysis of 44 cases]

We reviewed isolated sphenoid sinus lesion (ISL), a relatively uncommon entity found mostly in departments other than otolaryngology.

We retrospectively studied 44 cases of ISL at the Department of Otolaryngology, Kagoshima City Hospital, Kagoshima, Japan, for the 5 years between 1999 and 2003.

Data was obtained for each patient regarding age, present symptoms, first department visit, pathological classification, and therapy.

Eighty percent of patients first visited departments other than otolaryngology. Of these, 32 had inflammatory disease, 8 mucocele, 1 a benign tumor, and 3 malignant tumors. The most common symptoms were headache at 59% followed by ocular symptoms at 27%. Ocular symptoms included ocular pain in 60% of those with inflammatory disease, visual disturbance in 63% of those with mucocele, and diplopia in all of those with neoplasms.

The type of ocular symptom largely depends on ISL pathology. Patients with headaches and diplopia have a high ratio of malignant neoplasms. Endoscopic sinus surgery was useful in diagnosing and treating ISL in cases in which conservative therapy was ineffective. It is most important to differentiate pathological disease that requires early diagnosis and therapy such as acute inflammatory disease, mucocele with visual disturbance, and malignant tumors.