Isolated Sphenoidal Fungal Sinusitis, Presentation But Potentially Life Eatening Outcome

Abstract

Objective:  The objective of this study is that one should keep high index of suspicion for isolated fungal sinusitis in patients of unexplained headache and visual disturbances. Computed Tomography and Magnetic Resonance Imaging are the best diagnostic tools.

Study design:  Retrospective, descriptive study.

Place and duration of study:  Department of ENT and Head and neck surgery sheikh Zayed hospital Lahore from March 2001 to April 2005.

Patients and methods:  In this study twelve patients with a complaint o f headache and visual disturbance were investigated thoroughly and among all there were isolated sphenoidal fungal sinusitis which were explored endoscopically and proven on culture and histopathologically, in all patients oral itraconazole was given for six months.

Results:  In all patients headache improved 100% while visual changes like diplopia, improved in 5 patients 71%, cranial nerve palsies improved in 2 patients 40%.

Conclusion:  It is concluded that isolated sphenoidal sinus pathology should be excluded in patients having un-explained headache and visual disturbance .Computed Tomography / Magnetic Resonance Imaging are the investigations of choice for final diagnosis.

Key words:  Fungal sinusitis, sphenoid sinus.