Chronic sphenoid rhinosinusitis: management challenge

Charakorn, Natamon; Snidvongs, Kornkiat

doi:10.2147/jaa.s93023

Cited by 24 publications

(36 citation statements)

References 36 publications

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“…All patients in this study presented with headache of various intensity. This is comparable with other studies, as it was the presenting symptom in sphenoiditis in over 80% of cases in Charakorn N and Snidvongs K 4 and 77.7% in Marcolini T. R et. al.…”

supporting

confidence: 91%

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Isolated Sphenoiditis, Hidden Cause of Headache

Sulaiman¹

2019

Ann Coll Med Mosul

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Background: Many patients present to otorhinologists daily complaining of headache due to rhinosinusitis which generally has a specific findings. Nonetheless, isolated sphenoiditis is a rare type of sinusitis, but associated with more serious complications due to its contiguity with vital intracranial structures, and is usually associated with non-specific findings that may be missed as a cause of headache. Objectives: To highlight cases with headache due to isolated sphenoiditis that present with non-specific signs and symptoms of sinusitis, and to discuss the best methods of diagnosis and treatment to avoid serious complications. Patients and methods: A case series study of 27 patients (21 males, 8 females) aged between 18-32 years-old (mean age 25 years old), were evaluated during the period between June 2015 and December 2017 in the author's private clinic at PAR Hospital, Erbil, Iraq. Those patients were misdiagnosed as cases of primary headache (migraine or tension-type headache). The diagnosis of isolated sphenoiditis in those patients was based on clinical findings, nasal endoscopy and it was proved by computerized tomography scan. Results: The study was performed on adult patients, half of them were between 24-28 years-old, with a male to female ratio of 7:3. Headache was the presenting symptom with minimal expression of other symptoms of sinusitis, i.e.; nasal obstruction in 10 patients (37%), postnasal discharge in 5 patients (18.5%), visual symptoms in 3 patients (11%) and sneezing and itching in 6 patients (22%). Nasal endoscopic findings were negative in 5 patients (18.5%), while septal deviation was noted in 14 patients (52%), concha bullosa in 1 patient (3.7%), postnasal discharge in 5 patients (18.5) and granular pharyngitis in 10 patients (37%). Computerized tomography scanning of the paranasal sinuses was performed for all patients and proved the diagnosis of isolated sphenoiditis. Headache was relieved by medical treatment in 22 patients (81.5%). Five patients (18.5%) required surgical treatment. Conclusion: Although it is uncommon, isolated sphenoiditis must be suspected in patients with headache. It is a potentially dangerous disorder due to the contiguity of the sinus with vital neuro-vascular structures. Therefore, ENT specialists must be alert of this rare condition and radiological examination of paranasal sinuses should always be performed in prolonged and intractable cases of headache. Computerized tomography scan is the best tool in diagnosis and follow up of such cases.

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supporting

confidence: 91%

“…It is a different entity from other types of rhinosinusitis because patient may present with headache, visual loss or diplopia while nasal obstruction or nasal discharge may or may not be present. 4 In most cases of sphenoid sinusitis, symptoms do not appear early or are non-specific and this makes the diagnosis difficult…”

Section: Introductionmentioning

confidence: 99%

Isolated Sphenoiditis, Hidden Cause of Headache

Sulaiman¹

2019

Ann Coll Med Mosul

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“…Unfortunately, all current and even emerging treatment options are intended to ease one or several clinical symptoms often in association with other therapies including saline nasal washes, topical or oral antibiotics, nasal decongestants, steroids and anti-inflammatory drugs [13]. New emerging options include antimycotics, anti-IgE, anti-IL5, new antihistamines, complementary and alternative medicine, immunosuppressant medications, leukotriene inhibitors, phytotherapy, probiotics and proton pump inhibitors [15][16][17][18][19][20][21][22]. Despite such abundance of treatments available one wonders why none of them is really working and why even today, we don't have a cure for CRS.…”

Section: Discussionmentioning

confidence: 99%

“…A few patients of this study complained about moderate nasal irritation right after each TP application, lasting for about [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] seconds. This may be attributable to the fact that FPG solution is osmotic and draws intracellular hypotonic liquid as soon as it is sprayed as a film over the nasal mucosa.…”

Section: Discussionmentioning

confidence: 99%

Clinical Efficacy of a New Filmogen Polymeric Glycerol Solution for the Treatment of Rhinosinusitis

Rm¹,

Tourret²,

Schütte³

et al. 2017

J Clin Respir Dis Care

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Study background: The main cause of chronic rhinosinusitis is not yet well understood but increasing amount of evidence suggest an initial viral attack followed by secondary bacterial infection leading to the formation of a wellprotected reservoir of microorganisms in the sinuses where no treatment can easily reach. The efficacy of a new, non-irritant and moderately osmotic, polymeric glycerol filmogen solution was evaluated clinically.Methods: A 14-day, randomized, placebo-controlled, double blind, efficacy and safety clinical study was conducted with participation of thirty-eight patients treated with the filmogen polymeric glycerol vs. saline solution as comparator treatment used on sixteen control patients. Two to three nasal sprays were applied, three times daily over maximum fourteen days. Effects on rhinorrhea, nasal congestion, headache, facial pain, and sino-nasal outcome test were evaluated.Results: Rhinorrhea was much stronger in the test product group during the 1st three days compared to comparator and decreased drastically thereafter. Severity of all other rhinosinusitis symptoms also diminished in both groups but the reduction was much faster and stronger in the test group compared to comparator group (p<0.05), and led to minimized requirement for antibiotics. The test product was non-irritant and totally safe, no adverse effects being observed. Conclusion:Treating rhinosinusitis with a moderately osmotic solution capable of generating positive osmotic pressure yet non-irritant polymeric film constitutes a major breakthrough in the treatment of Rhinosinusitis.

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“…Einerseits kann sich eine isolierte Sinusitis sphenoidalis anhand mittig im Kopf wahrnehmbarer Schmerzen äußern, ggf. mit Ausstrahlung in die Scheitel-oder Schläfenregion [2]. Aufgrund der Symptomatik mit wässriger Rhinorrhoe und negativem β-Trace-Test sowie CT-morphologisch totalverlegter Zelle des Sinus sphenoidalis wurde zunächst eine Keilbeinhöhlen-Sanierung rechts angestrebt und durchgeführt.…”

Section: Diskussionunclassified