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Updated: Jul 11, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Neurological complications with acute sphenoid sinusitis a surgical emergency?
Markos Poulopoulos1, Pasquale F Finelli
1Department of Neurology, Hartford Hospital and University of Connecticut School of Medicine, 80 Seymour Street, Hartford, CT 06102-5037, USA.
Background:
Isolated acute sphenoid sinusitis is an uncommon sinus infection, frequently misdiagnosed and not usually considered in the differential diagnosis of acute severe headache, with the potential of serious neurologic complications.
Objectives:
To describe two patients with acute sphenoid sinusitis who presented with acute onset of severe headache and consider the role of surgical management.
Design:
Case report.
Setting:
Tertiary care hospital.
Results:
Patient 1 developed right cavernous sinus thrombosis and permanent visual loss in one eye, requiring sphenoidotomy following failure of medical treatment. Patient 2 experienced failure of the medical treatment. However, sphenoidotomy abated all his symptoms without any neurologic sequelae.
Conclusion:
It is important to be aware of acute sphenoid sinusitis in the setting of new onset severe headache, when imaging studies are unrevealing for intracranial pathology. Considering the serious consequences of failed medical treatment vis-à-vis the safety and efficacy of sphenoidotomy we propose surgical intervention at the time of diagnosis.
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Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
