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Kanjanawasee D, Chaowanapanja P, Keelawat S, et al. Sphenoid Sinus Cholesteatoma-Complications and Skull Base Osteomyelitis: Case Report and Review of Literature. Clin Med Insights Case Rep. 2019;12:1179547619835182doi: 10.1177/1179547619835182.
Kanjanawasee, D., Chaowanapanja, P., Keelawat, S., & Snidvongs, K. (2019). Sphenoid Sinus Cholesteatoma-Complications and Skull Base Osteomyelitis: Case Report and Review of Literature. Clinical medicine insights. Case reports, 121179547619835182. https://doi.org/10.1177/1179547619835182
Kanjanawasee, Dichapong, et al. "Sphenoid Sinus Cholesteatoma-Complications and Skull Base Osteomyelitis: Case Report and Review of Literature." Clinical medicine insights. Case reports vol. 12 (2019): 1179547619835182. doi: https://doi.org/10.1177/1179547619835182
Kanjanawasee D, Chaowanapanja P, Keelawat S, Snidvongs K. Sphenoid Sinus Cholesteatoma-Complications and Skull Base Osteomyelitis: Case Report and Review of Literature. Clin Med Insights Case Rep. 2019 Mar 05;12:1179547619835182. doi: 10.1177/1179547619835182. eCollection 2019. PMID: 30858746; PMCID: PMC6402053.
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Clin Med Insights Case Rep. 2019 Mar 05;12:1179547619835182. doi: 10.1177/1179547619835182. eCollection 2019.

Sphenoid Sinus Cholesteatoma-Complications and Skull Base Osteomyelitis: Case Report and Review of Literature.

Clinical medicine insights. Case reports

Dichapong Kanjanawasee, Pattraporn Chaowanapanja, Somboon Keelawat, Kornkiat Snidvongs

Affiliations

  1. Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
  2. Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
  3. Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
  4. Department of Pathology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

PMID: 30858746 PMCID: PMC6402053 DOI: 10.1177/1179547619835182

Abstract

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.

Keywords: cholesteatoma; endoscopic sinus surgery; osteomyelitis; skull base; sphenoid

Conflict of interest statement

Declaration of conflicting interests:The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: KS is a member o

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