Diagnosis and management of the opacified sphenoid sinus

The growing number of surgical procedures at the base of the skull makes a clear understanding of sphenoid disease and its anatomic relationships important for the modern otolaryngologist. We present five cases demonstrating the spectrum of sphenoid sinus disease, its systemic as well as local complications, and its surgical management. Pertinent anatomic and embryologic relations are reviewed and their diagnostic evaluation is discussed. Pitfalls in the diagnosis and management of these diseases are reviewed noting possible complications and significant danger points. The necessity for cooperation among the otolaryngologist, neurosurgeon, and ophthalmologist in the management of these entities is also demonstrated.