Isolated sphenoid sinus disease: An overlooked cause of headache

J Craniomaxillofac Surg. 2015 Nov;43(9):1914-7. doi: 10.1016/j.jcms.2015.08.025. Epub 2015 Sep 4.

Abstract

Objectives: The aim of this study was to evaluate patients who underwent endoscopic sphenoid sinus surgery for isolated sphenoid sinus disease. We also investigated the impact of sphenoid sinus surgery on headache intensity.

Material and methods: Twenty-one consecutive patients who underwent endoscopic sphenoidotomy for isolated sphenoid sinus disease were included in the study. Diagnosis of isolated sphenoid sinus pathology was based on history, physical examination, and radiologic evaluation. All patients had headache with various localizations. Pre- and postoperative headache intensity of patients was scored using a visual analogue scale (VAS).

Results: The most common location of headache was the vertex (24%). The preoperative and postoperative mean VAS scores for headache were 8.24 ± 0.94 and 2.67 ± 1.49, respectively. Statistical comparison revealed a significant improvement in headache intensity (p < 0.01). Polyps (33.3%) were the most common pathology, followed by inflammation (23.8%).

Conclusions: The most common presenting symptom of isolated sphenoid sinus disease is headache. In this study, we demonstrated that headache induced by isolated sphenoid disease can be relieved by endoscopic sphenoidotomy. Sphenoid sinus disease should be considered in the differential diagnosis of patients presenting with subacute or chronic headache.

Keywords: Fungal infection; Headache; Polyp; Sphenoid sinus.

MeSH terms

  • Adult
  • Child
  • Diagnosis, Differential
  • Female
  • Headache / diagnosis
  • Headache / etiology*
  • Headache / surgery
  • Humans
  • Male
  • Middle Aged
  • Mucocele / complications
  • Mucocele / diagnosis
  • Mucocele / surgery
  • Mycoses / complications
  • Mycoses / diagnosis
  • Mycoses / surgery
  • Nasal Polyps / complications
  • Nasal Polyps / diagnosis
  • Nasal Polyps / surgery
  • Paranasal Sinus Diseases / complications*
  • Paranasal Sinus Diseases / diagnosis
  • Paranasal Sinus Diseases / surgery
  • Paranasal Sinus Neoplasms / complications
  • Paranasal Sinus Neoplasms / diagnosis
  • Paranasal Sinus Neoplasms / surgery
  • Retrospective Studies
  • Sinusitis / complications
  • Sinusitis / diagnosis
  • Sinusitis / surgery
  • Young Adult