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[Clinical and diagnostic features in the phenotyping of isolated sphenoiditis]
R A Larin1, S V Krasilnikova2, P P Mokeeva3
1Semashko Nizhny Novgorod Regional Clinical Hospital, Nizhny Novgorod, Russia.
Abstract:
The relevance of the issues of diagnosis and treatment of isolated sphenoiditis (IS) is increasing, due to the widespread introduction into clinical practice of radiation diagnostic methods that allow the diagnosis, including latent forms of IS. Among the chronic forms of IS, polypous-cystic and fungal lesions of the sphenoid sinus (SS) predominate.
Objective:
To study the age, gender and radiological features of SS in patients with IS.
Material And Methods:
A retrospective observational single-center non-randomized study was conducted - an analysis of the case histories of 56 patients aged 18 to 68 years who were on inpatient treatment at the Semashko Nizhny Novgorod Regional Clinical Hospital (Department of Ear, Throat and Nose Diseases of the Privolzhsky Research Medical University) in the period 2018-2020, by age, gender composition, clinical and radiological manifestations in various forms of IS.
Results:
The duration of the disease was 59±19 days. Latent forms were detected in 40% of patients. Statistically, the polypous-cystic form of IS was diagnosed more often than the fungal one (z=4.2; p=0.001). The median age of patients with polypous-cystic and fungal IS was 46.5 [35.0; 59.0] years. Evaluation of computed tomograms on the Lund-Mackay scale showed higher values in patients with polypous-cystic IS than in patients with fungal SS lesion (p=0.07). Obstruction of the anastomosis was detected in 38 out of 50 (69.5%) patients with polypous-cystic IS and in 13 out of 50 (92.9%) patients with fungal IS.
Conclusions:
Against the background of a significant prevalence of rhinosinusitis, the absolute values of isolated sphenoiditis, even with a relative value of 5% of the total, are very significant. Determining the phenotype of isolated sphenoiditis and their features is very important for building a consistent treatment strategy. Age, gender, clinical and radiological manifestations should form the basis of phenotyping and further construction of a therapeutic and diagnostic algorithm.
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