MyMedR

Fulltext An unusual presentation of sphenoid Candida fungal ball: a case report

Tuang GJ, Zahedi FD, Akashah I, Lee JPH, Abidin ZAZ

J Surg Case Rep, 2019 Aug;2019(8):rjz240.

The clinical presentation of a sphenoid fungal ball (FB) is often non-specific and tends to be overlooked, particularly in hosts with an intact immune status. Rarely, potentially life-threatening complications may arise, owning its anatomical characteristics with contiguous structures. Herein, we present an unusual case of sphenoid FB complicated with orbital apex syndrome in an immunocompetent patient. The diagnosis dilemma and subsequent management are further discussed.

Matched MeSH terms: Sphenoid Sinus

Management of sphenoid lateral recess encephalocoeles

Govindaraju R, Tang IP, Prepageran N

Curr Opin Otolaryngol Head Neck Surg, 2019 Feb;27(1):37-46.

PMID: 30507693 DOI: 10.1097/MOO.0000000000000508

PURPOSE OF REVIEW: Sphenoid sinus lateral recess encephalocoeles (SSLRE) are rare occurrences and pose unique challenges due to limited surgical access for endoscopic endonasal repair and also the lack of consensus on optimal perioperative managements specifically in the spontaneous cases, which are also believed to be a variant of idiopathic intracranial hypertension (IIH). Endoscopic endonasal approaches have largely replaced the transcranial route and the techniques are continuously being refined to reduce the neurovascular morbidity and improve outcome.

RECENT FINDINGS: Transpetrygoid is the most utilized approach with modifications suggested to limit bone removal, exposure and preservation of the neurovascular structures as dictated by the extent of the lateral recess. As more experience is gained, extended transphenoidal techniques were also successfully used for access. Lateral transorbital is a new approach to the lateral recess investigated in cadavers. IIH treatment is still controversial in the setting of SSLRE, but it appears rationale to evaluate, monitor and treat if necessary.

SUMMARY: SSLRE management should be tailored to the specific anatomical variances and cause. Modifications of techniques have been described giving different options to access the lateral recess. Successful repair for spontaneous SSLRE may require treatment of IIH if present, but the long-term outcome is still unclear.

Matched MeSH terms: Sphenoid Sinus*

Anatomical variations of the sphenoid sinus and its adjacent structures: a review of existing literature

Anusha B, Baharudin A, Philip R, Harvinder S, Shaffie BM

Surg Radiol Anat, 2014 Jul;36(5):419-27.

PMID: 24146215 DOI: 10.1007/s00276-013-1214-1

The sphenoid sinus, one of the posterior groups of sinuses, has long been regarded as a 'neglected sinus' due to the anatomical location, poor understanding and poor accessibility, till the advent of endoscopes and modern imaging techniques. Increasing knowledge and greater understanding of this sinus has permitted an evolution in surgical practices and boundaries. Various literatures of the past report a great variety of rates of pneumatization, rates of optic nerve protrusion and dehiscence, as well as internal carotid artery (ICA) protrusion and dehiscence. One similarity noted among these studies is that the rates vary according to the ethnicity of the patients. Recommendations have also been made along the way with regard to modified surgical techniques. This review aims to describe the pneumatization of sphenoid sinus and the topographical relation of the optic nerve and ICA in different populations.

Matched MeSH terms: Sphenoid Sinus/anatomy & histology*; Sphenoid Sinus/radiography

Fulltext Prevalence of onodi cells in Hospital Raja Permaisuri Bainun, Ipoh, Malaysia

Tan KL, Harvinder S

Med J Malaysia, 2010 Jun;65(2):101-2.

PMID: 23756790 MyJurnal

Onodi cell is a posterior ethmoid air cell that pneumatizes into the sphenoid sinus, It is an important entity for clinicians when performing endoscopic sinus surgery (EES) because it encroaches into the optic nerve and internal carotid artery. CT-scans are the road map for ESS to prevent damage to structures mentioned above. Its prevalence in Malaysia is unknown.

Matched MeSH terms: Sphenoid Sinus*

Evaluation and treatment of isolated sphenoid sinus diseases

Tang IP, Brand Y, Prepageran N

Curr Opin Otolaryngol Head Neck Surg, 2016 Feb;24(1):43-9.

PMID: 26575516 DOI: 10.1097/MOO.0000000000000218

To review cause, clinical evaluation, medical and surgical management of isolated sphenoid sinus diseases.

Matched MeSH terms: Sphenoid Sinus/surgery*

Regression of a sphenochoanal polyp in a child

Lim WK, Sdralis T

Laryngoscope, 2004 May;114(5):903-5.

PMID: 15126753

To present an unusual case of a sphenochoanal polyp that regressed and review the etiology of such polyps in comparison to the commoner antrochoanal polyp.

Matched MeSH terms: Sphenoid Sinus/pathology*; Sphenoid Sinus/radiography*; Sphenoid Sinus/surgery

Fulltext Isolated sphenoid sinus lesion: A diagnostic dilemma

Alazzawi S, Shahrizal T, Prepageran N, Pailoor J

Qatar Med J, 2014;2014(1):57-60.

PMID: 25320694 DOI: 10.5339/qmj.2014.10

Isolated sphenoid sinus lesions are an uncommon entity and present with non-specific symptoms. In this case report, the patient presented with a history of headaches for a duration of one month without sinonasal symptoms. A computed tomography scan showed a soft tissue mass occupying the sphenoid sinus. An endoscopic biopsy revealed fungal infection. Endoscopic wide sphenoidotomy with excision of the sphenoid sinus lesion was then performed however, the microbiological examination post-surgery did not show any fungal elements. Instead, Citrobacter species was implicated to be the cause of infection.

Matched MeSH terms: Sphenoid Sinus

Fulltext Angioinvasive cerebral aspergillosis presenting as acute ischaemic stroke in a patient with diabetes mellitus

Norlinah MI, Ngow HA, Hamidon BB

Singapore Med J, 2007 Jan;48(1):e1-4.

PMID: 17245496

Cerebral angioinvasive aspergillosis is a rare manifestation of disseminated aspergillosis which may result in stroke in immunocompromised individuals. Reports of such disease in patients with diabetes mellitus are rare. We describe a 45-year-old man with diabetes mellitus who presented with a three-day history of right-sided limb weakness and aphasia. Cerebral computed tomography showed features of an acute infarct involving the left anterior and middle cerebral arteries. He was initially treated for an acute ischaemic stroke. Further history revealed that he was investigated for a growth in the sphenoid sinus two months earlier. Culture of the biopsied material from the sphenoid sinus grew Aspergillus fumigatus. Magnetic resonance imaging showed an extension of the growth to the brain, causing the acute ischaemic stroke. He was subsequently diagnosed with angioinvasive cerebral aspergillosis and was commenced on intravenous amphotericin B. Unfortunately, he succumbed to his illness despite treatment.

Matched MeSH terms: Sphenoid Sinus/microbiology; Sphenoid Sinus/pathology

Anatomical variants of surgically important landmarks in the sphenoid sinus: a radiologic study in Southeast Asian patients

Anusha B, Baharudin A, Philip R, Harvinder S, Shaffie BM, Ramiza RR

Surg Radiol Anat, 2015 Dec;37(10):1183-90.

PMID: 25990686 DOI: 10.1007/s00276-015-1494-8

Failure of a surgeon to understand the local variations of the anatomical landmarks of the sphenoid sinus is a potential risk factor to cause damage to the optic nerve (ON) or internal carotid artery (ICA) that lies on the walls of the sphenoid sinus. The aim of this study was to identify the anatomical variants of the sphenoid sinus and its related surrounding structures among the Southeast Asian (SEA) population, based on computed tomography (CT) scans.

Matched MeSH terms: Sphenoid Sinus

Fulltext Spontaneous temporosphenoidal meningoencephalo cele as a rare cause of non-traumatic cerebrospinal fluid rhinorrhoea

Bushra Johari, Hazman Mohd Nor, Kumar, Gnana, Narayanan, Prepageran

Neurology Asia, 2015;20(2):203-206.

MyJurnal

Cranial encephaloceles are rare conditions, which are more commonly seen in the anterior rather than in the middle cranial fossa. Temporal lobe encephalocele can present with a variety of clinical symptoms, amongst which include occult or symptomatic cerebrospinal fluid (CSF) fistula. We present a case of a patient with a short history of rhinorrhea who was found to have a CSF pool in the sphenoid sinus and right anteromedial temporosphenoidal encephalocele, which mimics sphenoid mucocoele, a much more common entity. This case highlights the imaging findings of temporosphenoidal encephalocoele and the diagnostic clues in differentiating this rare condition from the commoner mimics.

Matched MeSH terms: Sphenoid Sinus

A rare case of large sphenoethmoidal osteoma

Nazli Z, Abdul Fattah AW

Med J Malaysia, 2017 02;72(1):60-61.

PMID: 28255144 MyJurnal

Osteoma is the most common benign tumour of the nose and paranasal sinuses. However, involvement of the sphenoid sinus by osteoma is rare. Most of the time, patients with paranasal sinus osteoma are asymptomatic. However, symptoms may present, depending on the location and extension of the tumour. We report a case of a patient with sphenoethmoidal osteoma found incidentally on imaging, with evidence of impingement onto the optic nerve at the optic canal. However, the patient was asymptomatic. He was surgically treated using the endoscopic transnasal approach.

Matched MeSH terms: Sphenoid Sinus

Metastatic hepatocellular carcinoma presenting as a sphenoid sinus mass and meningeal carcinomatosis

Hashim H, Rahmat K, Abdul Aziz YF, Chandran PA

Ear Nose Throat J, 2014 Jun;93(6):E20-3.

PMID: 24932824

We report the case of a 30-year-old woman who was referred to us for evaluation of a 2-week history of fever, headache, vomiting, bilateral ptosis, and blurred vision. Imaging obtained by the referring institution had identified a sphenoid sinus mass and diffuse meningeal infiltration, which was thought to represent an infective process. We subsequently identified the mass as a metastatic hepatocellular carcinoma (HCC). The patient was placed under palliative care, and she died 1 month later. Metastases to the sphenoid sinus from any primary source are very rare, and they are generally not considered in the radiologic differential diagnosis. HCC is known to metastasize to the lung, lymph nodes, and musculoskeletal system; again, reported cases of metastasis to the sphenoid sinus are rare. Indeed, our review of the English-language literature found only 6 previously reported cases of sinonasal metastasis of a primary HCC. A diagnosis of a sinonasal metastasis is more difficult in a patient who has no previous diagnosis of a primary malignancy. In presenting this case, our aim is to remind readers of this possibility.

Matched MeSH terms: Sphenoid Sinus*

Fulltext Cerebrospinal fluid rhinorrhoea secondary to amyloidosis of the sphenoid sinus

Ali EA, Philip R, Prepageran N, Peh SC

Med J Malaysia, 2008 Oct;63(4):341-2.

PMID: 19385501 MyJurnal

Amyloidosis of the skull base is a rare entity. A patient with localized amyloidosis of the sphenoid sinus presented at our institution with cerebrospinal fluid rhinorrhoea. Endoscopic excision of the lesion and multilayered obliteration of the sphenoid sinus resolved the symptoms.

Matched MeSH terms: Sphenoid Sinus*

Ocular presentation of sphenoid mucocele

Prepageran N, Subramaniam KN, Krishnan GG, Raman R

Orbit, 2004 Mar;23(1):45-7.

PMID: 15513020

A sphenoid mucocele often presents late due to its deep-seated anatomical site. It has a varied presentation, due to its close relationship to the cavernous sinus and the base of the skull. It can present initially to the ophthalmologist with ocular complaints. In the present paper, the authors present two cases of sphenoid mucocele, one with an isolated third and one with an isolated sixth cranial nerve palsy.

Matched MeSH terms: Sphenoid Sinus/pathology*

Fulltext Maxillary Sinus Mucopyocele in a Fifty-eight-year-old man: A Possible Late Complication of Irradiation to Head and Neck

Sharouny H, Narayanan P

Iran Red Crescent Med J, 2014 Jul;16(7):e17133.

PMID: 25237579 DOI: 10.5812/ircmj.17133

INTRODUCTION: A mucocele is an epithelial-lined, mucus-containing sac that can fill the sinus completely and expand gradually. Mucopyocele is an infected mucocele.

CASE REPORT: We presented a case of left maxillary mucopyocele in a 58-year-old man that developed after radiotherapy for nasopharyngeal carcinoma. Computed tomography scan showed opacification of the left maxillary sinus expanding through the medial wall of the antrum with thinning and destruction of the adjacent structures. Endoscopic marsupialization of the lesion and left partial maxillectomy were performed. The cystic mass had yellowish thick mucopurulent fluid that was completely drained.

CONCLUSIONS: A few cases of sphenoid sinus mucocele as a late complication of radiation therapy have been reported. Maxillary mucocele and mucopyocele can be considered as one of the late complications of radiotherapy to head and neck as a result of occlusion of sinus ostia by scarred mucosa.

Matched MeSH terms: Sphenoid Sinus

Fulltext Endoscopic assisted transseptal transphenoidal hypophysectomy

Mallina S, Harvinder S, Rosalind S, Philip R, Gurdeep S, Anil S

Med J Malaysia, 2006 Aug;61(3):320-2.

PMID: 17240583 MyJurnal

Eight patients with pituitary tumors were operated via the transseptal transsphenoidal approach from April to November 2004 at Hospital Ipoh. Seven patients presented with visual disturbances while three also had endocrine abnormalities. The post-operative follow-up period was between six months to a year. There was no mortality in this series. There were no complications related to the approach i.e. nasal or septal related. All patients with visual impairment showed improvement. Only one patient had hormonal irregularities. The endoscopic assisted transseptal approach to the sphenoid sinus for pituitary surgery was found to be easy and without sinonasal or labial complications often found with the sublabial approach.

Matched MeSH terms: Sphenoid Sinus

Fulltext Minimally invasive surgical approaches to the sphenoid sinus, sella, parasellar and clival region: current and future perspectives

Gendeh BS

Med J Malaysia, 2006 Aug;61(3):274-7.

PMID: 17240574

Matched MeSH terms: Sphenoid Sinus

Fulltext Untreated Giant Macroprolactinoma with Chronic Cerebrospinal Fluid Leakage: An Unusual Complication

Mad Naser MN, Aziz NA, Karim NKA

Case Rep Endocrinol, 2019;2019:4825357.

PMID: 30766735 DOI: 10.1155/2019/4825357

Macroprolactinoma has the potential to cause base of skull erosion and often extends into the sphenoid sinus. Rapid shrinkage of this invasive tumor following dopamine agonist therapy has been postulated to cause unplugging of the eroded area, leading to cerebrospinal fluid leakage. To the best of our knowledge, the occurrence of spontaneous cerebrospinal fluid leak in treatment-naive prolactinomas is very rare, the majority of which involve undiagnosed macroprolactinomas. We describe here a lady presented late with giant macroprolactinoma, complicated by cerebrospinal fluid leakage. This case raised the dilemma in the management pertaining to the role of either pharmacotherapy or surgical intervention, or combination of both. As she strictly refused surgery, she was treated with bromocriptine which was later changed to cabergoline. On follow-up, there was cessation of cerebrospinal fluid leak, marked reduction of serum prolactin level, and imaging evidence of tumor shrinkage. The majority of patients with medically induced cerebrospinal fluid leakage will require surgical procedures to overcome this complication; however, there are isolated cases of leakage resolution on continuing dopamine agonist therapy while awaiting surgery. The use of dopamine agonist does not necessarily cause worsening of cerebrospinal fluid leakage and instead may produce spontaneous resolution as in this case.

Matched MeSH terms: Sphenoid Sinus

Fulltext Pneumatization of Mastoid Air Cells, Temporal Bone, Ethmoid and Sphenoid Sinuses. Any Correlation?

Hindi K, Alazzawi S, Raman R, Prepageran N, Rahmat K

Indian J Otolaryngol Head Neck Surg, 2014 Dec;66(4):429-36.

PMID: 26396957 DOI: 10.1007/s12070-014-0745-z

The aim of this study is to assess the pneumatization of the paranasal sinuses (PNS) and other parts of temporal bone such as mastoid air cells and to investigate if there was any association between the aeration of these structures among the three major ethnic groups in Malaysia (Malay, Chinese, Indian) as this would be representative of Asia. A retrospective review of 150 computed tomography (CT) scans of PNS and temporal bones was done and analysed. The pneumatization of each area was obtained and compared using statistical analysis. Patients with a history of previous medical or surgical problems in the intended areas were excluded from the study. The pneumatization of the mastoid air cells and other temporal bone parts were noted to be symmetrical in more than 75 %. There was a positive correlation between the pneumatization of mastoid air cells and that of the sphenoid sinus. The prevalence of Agger nasi, Haller's and Onodi cells was observed to be significantly higher in the Chinese group. Preoperative assessment of the temporal bone and PNS with CT scan may be helpful in the evaluation of their anatomical landmark and decrease the possibility of surgical complications related to 3D structures.

Matched MeSH terms: Sphenoid Sinus

Fulltext Ectopic Esthesioneuroblastoma of the Sphenoclivus: A Rare Entity

Zahedi FD, Gendeh BS, Husain S, Kumar R, Kew TY

Indian J Otolaryngol Head Neck Surg, 2017 Mar;69(1):125-129.

PMID: 28239593 DOI: 10.1007/s12070-016-0978-0

Esthesioneuroblastoma is a rare malignant neoplasm of oflactory neuroepithelium and usually located at the olfactory cleft at superior nasal cavity. Ectopic localization of esthesioneuroblastoma is even rarer and usually posed with a diagnostic dilemma and delay in the diagnosis and management, We report a rare case of ectopic esthesioneuroblastoma of the sphenoclivus with the presentation of intermittent unilateral epistaxis, intermittent intractable headache without anosmia. Nasal endoscopy findings showed a pulsatile mass at the anterior face of the sphenoid sinus with extension posteriorly towards the clivus region and occupying the floor of the sphenoid sinus. Endonasal transclival endoscopic excision of tumour was performed which involved otorhinolaryngology surgeon and neurosurgeon with intraoperative navigation imaging and frozen section. The histopathological findings was esthesioneuroblastoma. Due to its rarity and unusual presentation, the diagnosis of ectopic esthesioneuroblastoma is difficult and can be misdiagnosed with the other type of malignancy. Therefore, the histopathological result is important in confirming the type of tumour and can lead to the next step of management.

Matched MeSH terms: Sphenoid Sinus

Displaying publications 1 - 20 of 27 in total