Clinical analysis of isolated sphenoid disease first manifesting headache and/or ophthalmic symptoms

Objective: To improve the diagnosis and treatment of isolated sphenoid disease first manifesting headache and/or eye symptoms.

Methods: The clinical data of 25 cases suffering from isolated sphenoid disease first manifesting headache and/or eye symptoms from 1996 to 2005 were analyzed retrospectively, and the correlated documents were reviewed.

Results: In this group of the 25 patients, 21 failed to be diagnosed at the first time of medical consultation. The diagnosis confirmed by CT or MRI and pathology included 7 cases with isolated sphenoiditis, 4 with mycosis, 3 with sphenoid cysts, 6 with purulent sphenoid cysts, 2 with polyps and sphenoiditis, 1 with foreign body, 1 with craniopharyngioma, and 1 with oncocytoma. All of the patients underwent endoscopic sphenoid surgery. The symptoms of 24 cases of the patients were improved or disappeared after the operations.

Conclusions: This isolated sphenoid diseases were easily misdiagnosed. The diagnosis depends on CT or MRI and nasal endoscopy. CT by three-dimensional reconstruction can provide more special and precise information. Endoscopic sinus surgery is effective and safe technique for the treatment of the disease.