Isolated sphenoid sinusitis or mucocele: a potential complication of endonasal transsphenoidal surgery.
Rhinosinusitis/mucocele are rare complications of transsphenoidal surgery. We present a retrospective analysis of 323 patients who received transsphenoidal surgery for pituitary adenoma. Twenty of the 323 patients (6.2%) developed rhinosinusitis/mucocele after transsphenoidal surgery as shown by MRI. All 20 patients with rhinosinusitis/mucocele occurred in the group who received the small sphenoidotomy approach and simple postoperative nasal care. Medical management was successful in 13 of 20 cases (65%). The remaining seven patients received endoscopic sphenoidotomy. On re-operation, purulent pus was discovered in two, a necrotic fat graft in one, mucocele in one, a dropped tumor in two, and a bone chip in one. Sphenoid sinusitis resolved in all seven cases. The formation of sphenoid sinusitis/mucocele is related to the size of the sphenoidotomy, frequency of postoperative nasal care, and foreign body accumulation. Early surgical drainage is necessary in patients with rhinosinusitis/mucocele refractory to medical management to prevent ascending meningitis.
Lu
Yu-Jen
YJ
Department of Neurosurgery, Chang Gung Memorial Hospital, Chang Gung University Medical College, #5, Fu-Shin Street, Kwei-Shan Hsiang, Linkou, Taoyuan Hsien 333, Taiwan, ROC.
Chang
Chen-Nen
CN
Pai
Ping-Ching
PC
Wei
Kuo-Chen
KC
Chuang
Chi-Cheng
CC
D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009078:Mucocele / Q000209:etiology* / Q000473:pathology; D044583:Neuroendoscopy / Q000009:adverse effects; D010911:Pituitary Neoplasms / Q000601:surgery; D011183:Postoperative Complications; D012189:Retrospective Studies; D013101:Sphenoid Sinus / Q000601:surgery*; D015524:Sphenoid Sinusitis / Q000209:etiology* / Q000473:pathology