Table 1.
Clinico-epidemiological features of developmental and inflammatory sphenoid bone lesions. M male. F female. CN cranial nerve
| Developmental and inflammatory sphenoid lesions | Prevalence | Age (decade) of peak incidence of onset | Gender predilection | Clinical manifestations |
|---|---|---|---|---|
| Ecchordosis physaliphora [13] | Found in about 0.4–2% of autopsies | Congenital | M = F | Usually asymptomatic and does not require any treatment |
| Neurenteric cyst [21, 22] | Intracranial localization is rare (0.15–0.35% of all intracranial tumours); clivus localization is described in very few sporadic cases | III–IV decade | M = F | Often symptomatic with headache and diplopia |
| Arrested pneumatization [11, 24] | 2% in the general population; 10% in patients with blood-red cell diseases (sickle cell anaemia-thalassemia) | Congenital and developmental lesion | M = F | Headache and obstructive symptoms due to alterations of normal sinus drainage |
| Epidermoid cyst [31, 32] | Located in the head-neck area in 7% of cases | Often congenital. It can also occur in adult age for metaplasia or trauma | M = F | Symptoms are very rare. They generally occur in III-V decade and include visual disturbances (compression of CN II), infection due to adjacent sinusitis, and pituitary apoplexy in case of sellar extension |
| Fibrous dysplasia [37] | The skull is involved in 10–30% and 50% of monostotic and polyostotic forms respectively. Sphenoid is one of the main craniofacial areas | Congenital | M = F | Supraorbital headache is the most frequent symptom |
| Fungus ball (mycetoma) [7] | Typically affects the maxillary sinus. The sphenoid sinus is involved in about 20% of paranasal fungus balls | V-VI decade | M:F ratio = 3:7 | Frontal, retro-orbital, and occipital headache. Visual disturbances due to the CN II and VI impairment. Rarely asymptomatic |
| Mucocele [8, 9] | Sphenoid sinus is a rare localization for mucocele, accounting for 1–2% of all paranasal mucoceles | Any age | M = F | Posterior headache is the most common symptom. Visual disturbances may be associated when mucocele compresses CN II into the orbit and/or CN III, IV, and VI into the cavernous sinus |
| Osteomyelitis [10, 12] | < 2% and around 10% of all osteomyelitis in developed and developing countries, respectively | Any age | M:F ratio = 2:1 | Headache is commonly the only initial symptom |