Acute sphenoid sinusitis: management strategies

Acute sphenoid sinusitis is an uncommon disease with a significant morbidity. This paper reviews 14 patients presenting with acute sphenoid sinusitis between 1978 and 1987. Fifty-seven percent of patients had signs of neurological or ophthalmological complications, and 29% were left with permanent disabilities. Delay in diagnosis and treatment resulted in a morbidity of 80%. The organism most commonly cultured was Staphylococcus aureus, followed by Streptococcus pneumoniae. Haemophilus influenza, and other streptococci. While a trial of medical therapy for 24 hours is warranted in uncomplicated cases, we recommend surgical drainage of the sinus if medical therapy fails, and for all patients with complications.