Acute isolated sphenoid sinusitis in children.
OBJECTIVE
Acute infection of the sphenoid sinus usually affects both pre-adolescent and adolescent subjects and is associated with infections of the other paranasal sinuses. Acute isolated sphenoiditis, though uncommon, is frequently misdiagnosed as symptoms are vague and there are few clinical findings. Indeed, it is not usually diagnosed until the patient develops neurological complications. The aim of this report is to discuss our cases of acute isolated sphenoiditis and compare them with those reported in the International literature.


METHODS
We reviewed our 10-year records of paediatric patients affected by acute isolated sphenoid sinusitis, as confirmed by nasal endoscopy and/or CT scan, and compared them with paediatric cases of sphenoid sinusitis reported in literature. In particular, we focused on clinical findings, associated risk factors, diagnostic approach, and treatment.


RESULTS
As previously stated at the Brussels Consensus Meeting, patients can be separated into two groups on the basis of clinical findings: the first including patients affected by severe acute sphenoiditis presenting fever and headache, and frequently associated with neurological symptoms, with swimming and diving as possible predisposing factors. The second group includes patients with non-severe acute sphenoiditis, mainly associated with headache, allergic rhinitis being a possible predisposing factor.


CONCLUSIONS
Acute isolated sphenoid sinusitis appears to be difficult to diagnose, and there are few reports in peer-reviewed paediatric journals. We wish to alert paediatricians and ENT specialists of the importance of this rare but still potentially devastating disorder.
Marseglia
Gian Luigi
GL
Dipartimento di Scienze Pediatriche, IRCCS Policlinico San Matteo, Università di Pavia, Italy. gl.marseglia@smatteo.pv.it
Pagella
Fabio
F
Licari
Amelia
A
Scaramuzza
Cristina
C
Marseglia
Alessia
A
Leone
Maddalena
M
Ciprandi
Giorgio
G
D000208:Acute Disease; D000293:Adolescent; D002494:Central Nervous System Infections / Q000175:diagnosis* / Q000473:pathology; D016543:Central Nervous System Neoplasms / Q000175:diagnosis* / Q000473:pathology; D002648:Child; D003937:Diagnosis, Differential; D004724:Endoscopy / Q000379:methods; D005260:Female; D006261:Headache / Q000175:diagnosis / Q000473:pathology; D006801:Humans; D008297:Male; D012307:Risk Factors; D015524:Sphenoid Sinusitis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology* / Q000628:therapy; D014057:Tomography, X-Ray Computed