Isolated sphenoidal sinusitis in children

Abstract

Acute isolated infectious sphenoiditis should be considered in adolescents and pre-adolescents who present with constant moderate to severe oppressive headache. Awareness of this entity will enable early diagnosis and initiation of antibiotic treatment which is essential to avoid complications and surgical intervention.

Sphenoid sinusitis disguised by precocious puberty

“…Haimi-Cohen et al [1] reported eight children with isolated sphenoidit over a 2-year period. Predisposing factors are stated to include infected water entry into the sinus during swimming, cocaine abuse, steroid ingestion, immunosupressive therapy, craniofacial radiotherapy, diabetes mellitus, obstruction of the sinus ostium and maxillofacial trauma [3,4].…”

“…It occurs infrequently in pediatric patients, and when it does, it is usually in adolescents. It is often difficult to diagnose with conventional techniques as Caldwell, Waters and lateral sinus X-rays [1]. Fearson [2] detected only one case of isolated sphenoid sinusitis in the evaluation of 6770 children with sinusitis.…”

“…Isolated sphenoid sinusitis in childhood is an uncommon, potentially dangerous condition which is often misdiagnosed because of its nonspesific symptoms and paucity of clinical signs. It has been often detected secondary to investigations for its complications [1]. There have been no extensive review of isolated sphenoid sinusitis in children published in the literature.…”

Isolated sphenoid sinusitis presenting with unilateral VIth nerve palsy

“…Subdural and frontal lobe abscesses are also reported [6]. IS is most frequently presented with headache and orbital symptoms [3][4][5]. The headache is not characteristic and may involve frontal, temporal, retro-orbital, retrobulbar, occipital, or vertex regions [5,7].…”

“…Generally, nasal symptoms are not detected and patients may not be seen by an ENT specialist until an advanced stage or a radiological scan has been done [2]. The most encountered presentation of isolated sphenoid sinusitis is with headache and orbital symptoms [3][4][5].…”