Sphenoid Sinus Cholesteatoma—Complications and Skull Base Osteomyelitis: Case Report and Review of Literature
Introduction: Cholesteatoma of the paranasal sinuses is uncommon. Its clinical characteristics are an expanding growth of the affected paranasal sinuses consisting of keratinizing squamous epithelium with bony wall destruction. Among involved paranasal sinuses, sphenoid sinus cholesteatoma is the le...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2019-03-01
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| Series: | Clinical Medicine Insights: Case Reports |
| Online Access: | https://doi.org/10.1177/1179547619835182 |
| _version_ | 1819226196369473536 |
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| author | Dichapong Kanjanawasee Pattraporn Chaowanapanja Somboon Keelawat Kornkiat Snidvongs |
| author_facet | Dichapong Kanjanawasee Pattraporn Chaowanapanja Somboon Keelawat Kornkiat Snidvongs |
| author_sort | Dichapong Kanjanawasee |
| collection | DOAJ |
| description | Introduction: Cholesteatoma of the paranasal sinuses is uncommon. Its clinical characteristics are an expanding growth of the affected paranasal sinuses consisting of keratinizing squamous epithelium with bony wall destruction. Among involved paranasal sinuses, sphenoid sinus cholesteatoma is the least common. Case presentation: An 82-year-old female diabetic patient presented with subacute onset of fever after experiencing chronic progressive headaches for more than 20 years. Nasal endoscopy found purulent discharge from left sphenoethmoidal recess. Computed tomography (CT) scan of the paranasal sinus showed soft tissue lesions that totally filled the left sphenoid sinus with posterior and inferior wall destruction. There was no evidence of connection to the left mastoid cavity. Management and outcome: Left sphenoidotomy was performed. Histopathology revealed cholesteatoma. Two months after surgery, she became worse and CT showed extensive skull base destruction. The patient underwent bilateral sphenoidectomy and craniotomy with surgical debridement of osteomyelitis of the skull base. She received long-term intravenous ertapenam and sitafloxacin for treating drug-resistant Klebsiella infection. The osteomyelitis could not be controlled, and she died. Discussion: Progressive headache can be caused by an uncommon disease such as sphenoid sinus cholesteatoma, which is a surgical condition. Complicating osteomyelitis of the skull base requires extensive debridement surgery and should be anticipated. |
| first_indexed | 2024-12-23T10:21:39Z |
| format | Article |
| id | doaj.art-1d3f58e4b4394195bb83b869a7981d85 |
| institution | Directory Open Access Journal |
| issn | 1179-5476 |
| language | English |
| last_indexed | 2024-12-23T10:21:39Z |
| publishDate | 2019-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical Medicine Insights: Case Reports |
| spelling | doaj.art-1d3f58e4b4394195bb83b869a7981d852022-12-21T17:50:40ZengSAGE PublishingClinical Medicine Insights: Case Reports1179-54762019-03-011210.1177/1179547619835182Sphenoid Sinus Cholesteatoma—Complications and Skull Base Osteomyelitis: Case Report and Review of LiteratureDichapong Kanjanawasee0Pattraporn Chaowanapanja1Somboon Keelawat2Kornkiat Snidvongs3Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, ThailandDepartment of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandDepartment of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, ThailandEndoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, ThailandIntroduction: Cholesteatoma of the paranasal sinuses is uncommon. Its clinical characteristics are an expanding growth of the affected paranasal sinuses consisting of keratinizing squamous epithelium with bony wall destruction. Among involved paranasal sinuses, sphenoid sinus cholesteatoma is the least common. Case presentation: An 82-year-old female diabetic patient presented with subacute onset of fever after experiencing chronic progressive headaches for more than 20 years. Nasal endoscopy found purulent discharge from left sphenoethmoidal recess. Computed tomography (CT) scan of the paranasal sinus showed soft tissue lesions that totally filled the left sphenoid sinus with posterior and inferior wall destruction. There was no evidence of connection to the left mastoid cavity. Management and outcome: Left sphenoidotomy was performed. Histopathology revealed cholesteatoma. Two months after surgery, she became worse and CT showed extensive skull base destruction. The patient underwent bilateral sphenoidectomy and craniotomy with surgical debridement of osteomyelitis of the skull base. She received long-term intravenous ertapenam and sitafloxacin for treating drug-resistant Klebsiella infection. The osteomyelitis could not be controlled, and she died. Discussion: Progressive headache can be caused by an uncommon disease such as sphenoid sinus cholesteatoma, which is a surgical condition. Complicating osteomyelitis of the skull base requires extensive debridement surgery and should be anticipated.https://doi.org/10.1177/1179547619835182 |
| spellingShingle | Dichapong Kanjanawasee Pattraporn Chaowanapanja Somboon Keelawat Kornkiat Snidvongs Sphenoid Sinus Cholesteatoma—Complications and Skull Base Osteomyelitis: Case Report and Review of Literature Clinical Medicine Insights: Case Reports |
| title | Sphenoid Sinus Cholesteatoma—Complications and Skull Base Osteomyelitis: Case Report and Review of Literature |
| title_full | Sphenoid Sinus Cholesteatoma—Complications and Skull Base Osteomyelitis: Case Report and Review of Literature |
| title_fullStr | Sphenoid Sinus Cholesteatoma—Complications and Skull Base Osteomyelitis: Case Report and Review of Literature |
| title_full_unstemmed | Sphenoid Sinus Cholesteatoma—Complications and Skull Base Osteomyelitis: Case Report and Review of Literature |
| title_short | Sphenoid Sinus Cholesteatoma—Complications and Skull Base Osteomyelitis: Case Report and Review of Literature |
| title_sort | sphenoid sinus cholesteatoma complications and skull base osteomyelitis case report and review of literature |
| url | https://doi.org/10.1177/1179547619835182 |
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