Is this a sphenoid sinus infection? (photos)

I get headache on top of my head on the left side. Very precise area and pressure. Feel tired most of time and antibiotic haven't work. Is this something that require a different treatment?

Doctor Answers 2

Unique findings

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The CT scan suggests some boney uniqueness, such as possible fibrous dysplasia.  The left sphenoid sinus is small and involved in mucosal thickening.  Sinusitis in the broad sense, is swelling of the sinuses that is caused by many processes, such as an infection.  So this could be a left sided bacterial infection, or it could be simple non-infectious spenoid sinus membrane swelling and inflammation of some other uncertain cause such as allergies.  Also, of note, it is best to treat the symptoms, and not get too focused on what the CT scan shows.  See an experienced Otolaryngologist, one who has a lot of experience with sinus surgery.

Sphenoid sinusitis

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Thanks for your question. From these limited views it is difficult to provide a definitive answer. It looks like the left sphenoid never developed and the right is smaller than normal. There is no diseased lining or fluid levels that I see. I don't see any evidence of a bone tumor like fibrous dysplasia. Review the scans with an experienced sinus surgeon especially the adenoid area to see it there's a Thornwalds cyst as these can cause vertex headaches. Over 90% of patients who claim they have sinus headaches actually have migraines so that needs to be considered. Hope they find the cause and successfully treat it. 

Mark Loury, MD, FACS
Fort Collins Facial Plastic Surgeon

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