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Cavernous sinus thrombosis secondary to contralateral sphenoid sinusitis: a diagnostic challenge
A Eweiss1, W Mukonoweshuro, H S Khalil
1Department of Otolaryngology, Derriford Hospital, Plymouth, UK.
The Journal of Laryngology and Otology
|March 6, 2010
Summary
Contralateral sphenoid sinusitis can cause cavernous sinus thrombosis. Prompt endoscopic sphenoidotomy and medical treatment successfully resolved this life-threatening condition.
Area of Science:
- Otolaryngology
- Neurology
- Radiology
Background:
- Sphenoid sinusitis is an infection of the sphenoid sinuses, which are located deep within the skull.
- Cavernous sinus thrombosis is a rare but serious bacterial infection of the cavernous sinus, a dural venous sinus located at the base of the skull.
Observation:
- A 62-year-old man with a history of temporal headache, initially diagnosed as temporal arteritis, developed proptosis, ophthalmoplegia, and ptosis.
- Initial imaging suggested a carotid-cavernous fistula, but this was ruled out by cerebral angiography.
- Review of imaging revealed right cavernous sinus thrombosis secondary to left sphenoiditis.
Findings:
- The patient underwent urgent endoscopic sphenoidotomy and received medical treatment.
- All neurological and ophthalmological symptoms and signs resolved dramatically following the intervention.
Implications:
- This case highlights that sphenoiditis can lead to contralateral cavernous sinus thrombosis, a potentially fatal complication.
- Early diagnosis and prompt surgical and medical management, including endoscopic sphenoidotomy, are crucial for successful outcomes in such cases.
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