Background and Objectives: Isolated sphenoid lesion (ISL) is rare due to its anatomic location in the nasal cavity. The recent advances in the diagnosis with CT and MRI make it easier to diagnose ISL. We experienced 15 cases of ISL and reviewed their clinical characteristics.
Materials and Methods: Patients with ISL admitted from January 1998 through April 2004 were retrospectively reviewed. Patients’ clinical symptoms, endoscopic and radiologic findings, treatment modalities, postoperative diagnosis, and the outcomes were analyzed.
Results: The most common symptom was headache presented in 9 patients, followed by nasal symptoms in 4 patients. Five of 15 cases were acute sphenoiditis which was improved with antibiotic trials. The other 10 cases were treated by endoscopic sphenoidotomy. Postoperative pathology showed 4 cases of fungal ball, and 3 cases of mucocele, 3 cases of chronic sphenoiditis.
Conclusion: Headache and orbital symptom were the most common presentation in patients with ISL. Endoscopic and radiologic findings were not pathognomonic to diagnose ISL in most cases. Antibiotic trials should be preceded, and then followed by endoscopic sphenoidotomy in the refractory cases. Loss of vision or light reflex may predict a poor rognosis.
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