The complications of sphenoid sinusitis

Bilateral Blindness Due to Acute Isolated Sphenoid Sinusitis- Is It Reversible? A Case Report

“…Direct compressive effect over the dehiscent optic nerve or optic chiasma can also lead to blindness. 12 In our case computed tomographic scan showed erosion of the roof of sphenoid sinus. We suspect that pressure over the optic chiasma could have lead to blindness.…”

“…which was reversed by prompt treatment. 6,8,9,10,12 The return of blindness following acute sphenoid sinusitis depends on many factors. Prompt surgical management before irreversible changes occur and the degree of visual loss are important factors having prognostic significance.…”

Optic Neuropathy and Sinus Disease

“…Direct spread of the sinus infection to the optic nerve is probably the most common way in which this occurs [5]. Osteomyelitis affecting the sinus walls secondary to chronic infection may also be in direct contact with the nerve [6].…”

“…Visual loss in association with sphenoid sinusitis should be considered a rhinological emergency [6]. Parenteral antimicrobial therapy is recommended as the first-line treatment.…”

Intracranial extension of sphenoid sinusitis

“…' Dale and Mackenzie' concluded that surgical management in cases of sinus disease is required when symptoms persist despite antibiotic ther-apy, abscess size is unchanged or increased radiologically, or neurologic symptoms and signs appear. 8 The objective is to achieve concurrent drainage or excision of the primary sinus disease and the secondary intracranial suppuration. Six methods of surgical drainage of the sphenoid sinus were described by Dale and Mackenzie, ranging from washouts through the anterior sinus wall or ostium, to intranasal sphenoidotomy, and transseptal, transethmoidal, or transantral sphenoidotomy.'…”