Isolated sphenoid sinusitis: A big headache

Isolated sphenoid sinusitis is a rare clinical entity with potentially devastating complications such as cranial neuropathies, cavernous sinus thrombosis, meningitis and intracranial abscess. It accounts for only 2.7–3.0% of all paranasal sinus diseases.1 A patient may present with myriad symptoms, ranging from occipital or vertex headache, retro-orbital pain, otalgia, drowsiness to meningitis-like symptoms. With these non-specific and varied symptoms, patients are usually not referred to an otorhinolaryngologist, which contributes to further delay in diagnosis and proper management. Prompt and accurate diagnosis is necessary in order to avoid catastrophic complications due to the proximity of the sphenoid sinus to vital neurovascular structures.