Isolated sphenoethmoidal pattern sinusitis

Case contributed by Abdel-Rahman Abdel-Halim
Diagnosis certain



Patient Data

Age: 19
Gender: Female

Obliterated left sphenoethmoidal recess with subsequent opacification of the  left sphenoidal sinus and left posterior ethmoidal air cells by polypoidal mucosal thickening.

The rest of paranal sinuses are clear. The right sphenoethmoidal recess and both ostiomeatal units are patent.


Case Discussion

There are five main patterns of chronic inflammatory disease that classify the disease into distinct anatomical/pathological groups, and are dependent on the drainage pathways affected:

  1. Ostiomeatal complex pattern: maxillary sinus, anterior ethmoid air cells and frontal sinuses are affected due to obstruction of the ostiomeatal complex. 

  2. Infundibular pattern: isolated obstruction to the ethmoid infundibulum and/or maxillary sinus ostium. 

  3. Sphenoethmoidal recess pattern: inflammatory changes in the sphenoethmoidal recess obstruct the sphenoid sinus in isolation or in conjunction with the posterior ethmoidal air cells.

  4. Sinonasal polyposis pattern: extensive polyps are occupying the nasal cavity and the paranasal sinuses. 

  5. Sporadic pattern: no clear pattern could be identified with random mucosal thickening, polyps. 

This classification helps the surgeon to select the type of surgery needed. 

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