Authors: B V Manjula Arun B Nair A M Balasubramanyam Shantanu Tandon Ravi C Nayar
Publish Date: 2010/06/04
Volume: 62, Issue: 1, Pages: 69-74
Abstract
All 8 patients aged 17–63 managed surgically in the department of ENT and Head and Neck Surgery at St John’s Medical College and Hospital Bangalore from 2006 to 2008 for ISSD Demographic data presenting signs and symptoms endoscopic and imaging findings surgical management surgical pathology and clinical outcomes were investigated in the above patientsOf the 8 cases of ISSD 5 were male 3 were female with an age range of 17–63 years The most common presenting symptom was headache 7 patients 875 followed by nasal obstruction and recurrent URTI 5 cases 625 Imaging included CT and/or MRI studies in all cases Sphenoid sinus pathology was varied and included 5 625 inflammatory cases 1 111 cerebrospinal fluid fistula and 2 222 cases of sphenoid sinus neopasms Of the inflammatory cases 2 40 had isolated polyps in the sphenoid sinus sphenochoanal polyps and 3 60 had fungal sinusitis Treatment was surgical endoscopic transnasal sphenoidotomy under general anesthesia in all 5 patients with inflammatory ISSD Two patients with sphenoid sinus tumors underwent endoscopic biopsyISSD is rare A high index of suspicion is required for diagnosis which should be an active process and not one of exclusion Both diagnostic nasal endoscopy and CT imaging are essential for diagnosis The direct approach to the sphenoid sinus transnasal endoscopic sphenoidotomy without ethmoidectomy is safe and effective With early and adequate surgery we were able to avoid the morbidity associated with ISSD
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