title: Management of isolated sphenoid sinus disease in children: a surgical perspective.
abstract: OBJECTIVE
  To determine the spectrum of diseases and optimal timing of surgical drainage for the opacified sphenoid sinus in children.
  
  
  METHODS
  Ten year retrospective chart review of children with isolated sphenoid sinus disease.
  
  
  RESULTS
  Fourteen patients (mean age 11 ± 2.8 years, range 6.5-15.1 years) were diagnosed with isolated sphenoid sinus disease. Five patients had acute, severe bacterial sphenoiditis, four had sphenoid mucoceles, three had suspected tumors involving the sphenoid bone, clivus or sella, and two were identified incidentally when imaging studies were obtained for unrelated reasons. Headache was the most common symptom. Cranial nerve or other intracranial complications were present in all of those referred because of infection, but in none of the other patients. Computed tomography (CT) revealed the presence of disease in all cases. Compared with CT, magnetic tomography (MRI) was more helpful in identifying the extent of disease spread in two patients with acute bacterial sphenoiditis and in three patients with suspected tumors. All improved with surgical drainage or biopsy of the suspected tumor. In two cases, children were treated conservatively with antibiotics and the primary symptoms resolved.
  
  
  CONCLUSIONS
  Isolated sphenoid sinus disease is rare in children. Those with clinically significant disease presented with progressive, severe headaches and minimal sinus symptoms. MRI studies were important to identify the source of headache and evolving complications in several of these patients.
authors: Division of Otolaryngology, The Children's Hospital of Philadelphia, Philadelphia, PA 19104, United States. elden@email.chop.edu
authors: Lisa M
authors: LM
authors: Elden
authors: Megan E
authors: ME
authors: Reinders
authors: Ken
authors: K
authors: Kazahaya
authors: Lawrence W C
authors: LW
authors: Tom
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001424:Bacterial Infections / Q000175:diagnosis; D002648:Child; D004322:Drainage; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D008297:Male; D009078:Mucocele / Q000175:diagnosis / Q000601:surgery; D010254:Paranasal Sinus Diseases / Q000175:diagnosis / Q000601:surgery*; D010255:Paranasal Sinus Neoplasms / Q000175:diagnosis / Q000601:surgery; D012189:Retrospective Studies; D013101:Sphenoid Sinus; D015524:Sphenoid Sinusitis / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed