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Acute sphenoid sinusitis leading to contralateral cavernous sinus thrombosis: a case report

  • S R Dyer (a1), P J Thottam (a1), S Saraiya (a1) and M Haupert (a1)

Abstract

Introduction:

The objective of this article was to report a case of isolated, acute, right-sided sphenoid sinusitis that progressed to contralateral cavernous sinus thrombosis in an 18-year-old male patient. We describe the atypical presentation of this case and discuss the relevant anatomy, pathogenesis, presentation, diagnostic evaluation and treatment.

Case report:

A case report of sphenoid sinusitis leading to contralateral cavernous sinus thrombosis was reviewed and presented along with a comprehensive literature review of the relevant anatomy, pathophysiology, microbiology, diagnostic work-up and treatment options.

Conclusion:

Cavernous sinus thrombosis is a rare clinical entity in the antibiotic era. However, limited sphenoid sinusitis may progress to cavernous sinus thrombosis in spite of maximal medical treatment, as highlighted in this case report. The mainstay of treatment includes early diagnosis allowing aggressive intravenous antibiotics and appropriate surgical management.

Copyright

Corresponding author

Address for correspondence: Dr P J Thottam, Department of Otolaryngology – Head and Neck Surgery, Children's Hospital of Michigan, 1005 Michigan Catalpa Drive, Royal Oak, Detroit, MichiganUSA, 48067 Fax: +1 313 745 5848 E-mail: pthottam@gmail.com

References

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1Eweiss, A, Mukonoweshuro, W, Khalil, HS. Cavernous sinus thrombosis secondary to contralateral sphenoid sinusitis: a diagnostic challenge. J Laryngol Otol 2010;124:928–30
2Bhatia, K, Jones, NS. Septic cavernous sinus thrombosis secondary to sinusitis: are anticoagulants indicated? A review of the literature. J Laryngol Otol 2002;116:667–76
3Younis, RT, Lazar, RH. Cavernous sinus thrombosis: successful treatment using functional endonasal sinus surgery. Arch Otolaryngol Head Neck Surg 1993;119:1368–72
4Cannon, ML, Antonio, BL, McCloskey, JJ, Hines, MH, Tobin, JR, Shetty, AK. Cavernous sinus thrombosis complicating sinusitis. Pediatr Crit Care Med 2004;5:86–8
5DiNubile, MJ. Septic thrombosis of the cavernous sinuses. Arch Neurol 1988;45:567–72
6Lew, D, Southwick, FS, Montgomery, WW, Weber, AL, Baker, AS. Sphenoid sinusitis. A review of 30 cases. N Engl J Med 1983;309:1149–54
7Southwick, FS, Richardson, EP Jr, Swartz, MN. Septic thrombosis of the dural venous sinuses. Medicine (Baltimore) 1986;65:82106
8Younis, RT, Lazar, RH. Cavernous sinus thrombosis: successful treatment using functional endonasal sinus surgery. Arch Otolaryngol Head Neck Surg 1993;119:1368–72
9Price, CD, Hameroff, SB, Richardson, RD. Cavernous sinus thrombosis and orbital cellulitis. South Med J 1971;64:1243–7

Keywords

Acute sphenoid sinusitis leading to contralateral cavernous sinus thrombosis: a case report

  • S R Dyer (a1), P J Thottam (a1), S Saraiya (a1) and M Haupert (a1)

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