2021 Volume 64 Issue 2 Pages 92-100
The sphenoid sinus is close to the optic canal and cavernous sinus, and direct extension of inflammation from the sphenoid sinus to the cavernous sinus causes severe headache and nausea, and sometimes meningitis and epidural abscess. We report a case of acute sphenoid sinusitis in which the inflammation spread to the cavernous sinus.
A 47-year-old woman was admitted to a neighborhood otolaryngology clinic with the chief complaints of headache and nausea. Cranial CT and MRI showed left sphenoid sinusitis, and the patient was referred to our department for further examination and medical treatment. Imaging examinations revealed spread of acute inflammation from the sphenoid sinus to the left cavernous sinus; the patient was urgently admitted to our department on the same day and started on treatment with the appropriate antibiotics. On the day after hospitalization, the patient complained of severe headache and nausea, and endoscopic sinus surgery was performed for drainage of the sphenoid sinus. After the operation, the patient recovered without any sequelae, such as diplopia or meningitis, and was discharged on the 17th hospital day.
Since early diagnosis and treatment influence the prognosis after the spread of inflammation to the cavernous sinus, it is very important to identify the causative bacteria and administer the appropriate antibacterial drugs, in addition to surgical drainage.
