Aspergillus sp. are the most common contaminants found in the paranasal fungal sinusitis, but isolated sphenoid sinus invasion is extremely rare. According to sinus anatomy and depending on its contiguous structures, various symptoms and
complications
may appear. Of these symptoms and complications, headaches are the most frequently observed in the few documented cases. The treatment is primarily surgical, through either transnasal or transethmoid approach, depending on whether or not the
disease is
limited to the sphenoid sinus. The transnasal endoscopic technique offers excellent visualization and an atraumatic approach to the sphenoid sinus. It is performed with the superior turbinate used as the key landmark for identification. For this
technique, a wide enlargement of the natural sphenoid ostium is also important. Along with a review of literature, we present two cases of sphenoid sinus aspergillosis which were successfully treated by transnasal endoscopic sphenoidotomy.
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