A case of organized hematoma of the sphenoid sinus removed by endoscopic nasal surgery

Abstract

Organized hematoma is a general term for mass-forming lesions caused by hemorrhage and inflammation. Most organized hematomas occur in the maxillary sinus, whereas those in the sphenoid sinus are extremely rare. In this study, we report a case of organized hematoma in the sphenoid sinus that was successfully removed by endoscopic nasal surgery. The mass showed a slow increase in size, and bone destruction could be observed on imaging, which required differentiation from malignancy. Preoperative biopsy alone is often not sufficient to make a diagnosis, but the characteristic imaging findings, together with the clinical picture and biopsy results, allow for a preoperative diagnosis. An accurate preoperative diagnosis is important to avoid unnecessary extensive surgery. However, the sphenoid sinus is located in close proximity to important organs, such as the dura mater, making complete resection difficult in some cases. Preoperative angiographic evaluation of blood flow and adequate surgical planning are necessary for safe complete resection.