Sphenoiditis – Is Surgery Necessary?

Proven content

Sphenoiditis is a condition caused by superinfection of previously damaged mucosa in the nose or sinuses. The sphenoid bone is shaped like a butterfly with its wings spread out. In its center there are two sphenoid sinuses; in the center of the butterfly. This is the most pleasant aspect of their existence, because although few people know about them, they can be the source of many problems, and improper treatment may end tragically for the patient.

Sphenoiditis – high-risk sinus

The sphenoid sinuses are located at eye level, however deep – the deepest of all sinuses, and therefore they are classified as secondary sinuses. This position is their blessing and curse at the same time. To get to them, bacteria, allergens and contaminants must break through quite powerful barricades of the nasal cavities, armed with thick mucus, hairs and cilia, and a barrier of shallower sinuses that take on the attack of inflammatory agents, so the sphenoid sinuses are rarely affected by inflammation. However, once the sphenoid sinusitis occurs, the difficult access complicates the diagnosis and, in extreme cases, the operation. After all, sick sphenoid sinuses cannot be left alone.

Is diagnosis of sphenoid sinus difficult?

Wojciech Gawron, MD, PhD from the Lower Silesian Laryngology Center Medicus says: – It happens that the sphenoid sinusitis comes to light during the diagnosis of other diseases within the skull: in MRI or CT, even though it did not show any symptoms before. We call them radiological inflammation. It requires naturally active treatment, first conservative and, in special cases, surgical, but it is clinically evident sphenoiditis, i.e. Parietal headaches and high temperature are potentially serious issues. If the sphenoid sinus is not stopped in time, it can spread beyond the sinus area, e.g. to the meninges. Complications can be fatal and can even result in the patient’s death.

Thirty-year-old Klara from Warsaw has undergone two operations on the sphenoid sinus. The first time she was still in high school, and helpless in the face of her crippling headaches, the doctors first imputed her hysteria, and then began looking for a brain tumor. Anyway, it was thanks to such an exploratory tomography that the neurologist discovered the inflammation of the sphenoid sinus. Earlier, an X-ray of the nasal sinuses was taken, but they were clean, so this trail was abandoned. The second time, ten years later, Klara was wiser and she told doctors herself where to look for the source of the headache.

What pain is associated with sphenoiditis?

She would like to help others identify this kind of pain, but she wonders if it is even possible:

– I already know him, but I do not know if someone who has not experienced it will be able to recognize this sensation. The head hurts a lot. And all the time. First, over-the-counter painkillers provide temporary relief, then nothing helps. A man falls asleep with pain and wakes up with it, although he always hopes that the next day will pass. But it doesn’t. It lasts for days, weeks, months. The pain in the inflammation of the sphenoid sinus is located in the very center of the head, and although it radiates towards the back of the head, especially when tilting the head back, to the eye sockets and temples, you can feel that it is not the head ache as such, but something in it, some sick element as I call it “heart of darkness”. Now I know that this testicle was the sphenoid sinus.

Apart from the headache, Klara suffered from visual disturbances during sphenoiditis. They happened, for example, when she looked at a metro train or a tram moving. The view was disturbed and she felt a moment of nausea. She could also feel a thick secretion running down the back of her throat, and she had dark circles under her eyes impossible to mask with concealer.

Each of Klara’s operations lasted about two hours. The first time, apart from cleaning the sphenoid sinus, she also performed a correction of the nasal septum, the second time was the plastic surgery of the nasal turbinates. Before the second operation, in addition to the head tomography, she underwent a posterior rhinoscopy under local anesthesia, i.e. nose endoscopy with a mirror. In this way, the ENT doctor assessed the possibility of reaching the sphenoid sinus. Klara admits that she was very scared before both operations.

Sphenoiditis – surgery

Wojciech Gawron, MD, PhD confirms that the procedure is not easy: – The sphenoid sinuses are placed in an unfortunate place, near the optic nerve and cavernous sinus. They are so difficult to access that during the operation it may be necessary to irreversibly destroy certain anatomical structures, e.g. the nasal septum. Therefore, not every center undertakes this type of surgery, and the indications for surgery must be absolute: the balance of profits must exceed the balance of losses. However, thanks to endoscopic techniques, navigating the sphenoid sinus is now easier than it used to be.

Convalescence after sinusitis

Klara warns the patients who are still waiting for the operation that the symptoms of the sphenoid sinusitis do not go away as he took it away, the convalescence must take time. – I was exhausted by the headache, but after the surgery the pain continued. It took several months to fully recover, but I must admit that immediately after the surgery I felt that I had more space in my head. It was a relief. Then everything healed, blood clots flowed from my nose, I had to spare myself for three months, playing sports was out of the question. But after the recovery period, the quality of life turns out to be incomparable. Life without permanent pain is beautiful. My only concern is that the sphenoiditis doesn’t recur since I’ve had it twice.

Can you prevent sinusitis?

Among the factors contributing to the inflammation of the sphenoid sinus, Dr. Wojciech Gawron from the Lower Silesian Laryngology Center Medicus mentions:

1. disorders of the anatomy of the nose,
2. allergies,
3. polypy,
4. cystic fibrosis.

Klara urges those suffering from an unidentified headache to suggest to the doctor the possibility, not always taken into account, that it is the effect of sphenoid sinus inflammation and that it sensitizes parents to investigating the causes of headaches in children. It also signals that the first night after surgery is hard. He cannot imagine her outside the hospital, without access to strong painkillers and intravenous antibiotics. This is important because she has met with doctors who offer surgery on the sphenoid sinus, after which you can go home the same day. And most of all, the “veteran” urges us to realize that inside the bone butterfly immobilized in our skull there is a potential core of darkness, which must not be underestimated.

In order to relieve pain related to the sinuses, use Visiomed Gel Compress – an eye mask for thermotherapy. It is convenient to use and can help with pain relief. It is also worth supporting the body with appropriate supplementation. We recommend, for example, Na Zatoki – Panaseus dietary supplement available at a promotional price on Medonet Market.

Text: Julia Wolin

Consultation: Wojciech Gawron, MD, PhD from the Lower Silesian Laryngology Center Medicus