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Isolated Sphenoid Sinus Disease in Children
Michal Kotowski1, Jaroslaw Szydlowski1
1Department of Pediatric Otolaryngology, Poznan University of Medical Sciences, 60-572 Poznan, Poland.
Insights
Isolated sphenoid sinus disease (ISSD) in children is rare and requires specific analysis. Surgical treatment is effective, with most pediatric patients experiencing symptom relief and no complications.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Rhinosinusology
Background:
- Isolated sphenoid sinus disease (ISSD) is uncommon, particularly in pediatric populations.
- This necessitates a dedicated analysis of clinical presentations and management strategies in children.
Purpose of the Study:
- To analyze clinical manifestations, radiological findings, and surgical outcomes in a cohort of exclusively pediatric patients with ISSD.
- To provide insights into the management of this rare condition in a specific age group.
Main Methods:
- Retrospective analysis of medical data from 28 surgically treated pediatric patients (aged 5.5-17.5 years).
- Evaluation of presenting symptoms, radiographic findings, surgical approaches, histopathology, and follow-up data.
Main Results:
- Headache was the dominant symptom (78%). Visual symptoms (diplopia, visual acuity disturbances) occurred in four patients.
- Common diagnoses included chronic isolated rhinosinusitis (16), mucocele (6), and sphenoiditis with polyp (1). Neoplastic lesions and bony abnormalities were rare.
- The transnasal approach was most common (86%). All patients with visual symptoms improved post-surgery, with no observed complications.
Conclusions:
- ISSD in children presents with varied symptoms, with headache being most prevalent.
- Minimally invasive surgical approaches are effective for pediatric ISSD, leading to good outcomes and rapid recovery of visual function when affected.
- Fungal etiology is rare, and prompt surgical intervention is crucial for visual loss associated with ISSD.
Abstract:
The rarity of isolated sphenoid sinus disease (ISSD) and the specificity of pediatric populations meant that a separate analysis was required in this study. This study aimed to present and discuss the results of an analysis of clinical manifestations, radiological findings and surgical methods based on a large series of exclusively pediatric patients. The study group covered 28 surgically treated children (aged 5.5-17.5 years). The medical data were retrospectively analyzed and meticulously discussed with regards to presenting signs and symptoms, radiographic findings, surgical approaches, complications, post-op care, histopathological results and follow-ups. The dominant symptom was a persistent headache (78%). Four children presented visual symptoms, diplopia in two cases, visual acuity disturbances in one case and both of these symptoms in one patient. Sixteen children presented chronic isolated rhinosinusitis without nasal polyps, six suffered from mucocele and one presented chronic sphenoiditis with sphenochoanal polyp. Four patients turned out to exhibit neoplastic lesions and developmental bony abnormality was diagnosed in one case. No fungal etiology was revealed. The transnasal approach was used in 86% of patients. A transseptal approach with concurrent septoplasty was used in four patients. The patient with visual acuity disturbances completely recovered after the surgery. All children with visual symptoms reported improvement in the vision immediately after surgery. No postoperative complications were observed. Fungal etiology was extremely rare in the pediatric population with ISSD. The surgical treatment should be a minimally invasive procedure regarding a limited range of the pathology in ISSD. Emergency surgery should be performed if ISSD produces any visual loss.
