Organized Hematoma of the Sphenoid Sinus With Acute Blindness: Insight Into Pathogenesis of Disease

Ear Nose Throat J. 2020 Nov;99(9):605-609. doi: 10.1177/0145561320941959. Epub 2020 Jul 20.

Abstract

Sinonasal organized hematomas (OHs) are rare lesions that primarily localize to the maxillary sinus. The rate of growth of these masses has not been described in the literature. We present a case of a 59-year-old gentleman with polyostotic fibrous dysplasia who presented with acute loss of vision in the left eye from an expanding OH of the sphenoid sinusitis. After expanded endonasal, transpterygoid approach and debulking, patient experienced significant vision improvement. Close follow-up imaging preoperatively allowed radiologic documentation of the rate of OH growth and this is presented in detail.

Keywords: acute visual loss; chronic sinusitis; fibrous dysplasia; optic nerve compression; organized hematoma; organizing hematoma; sphenoid sinusitis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blindness / etiology*
  • Diagnosis, Differential
  • Epistaxis / etiology
  • Female
  • Hematoma / complications*
  • Hematoma / diagnostic imaging
  • Hematoma / pathology
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Paranasal Sinus Diseases / complications*
  • Paranasal Sinus Diseases / diagnostic imaging
  • Paranasal Sinus Diseases / surgery
  • Sphenoid Sinus / diagnostic imaging*
  • Sphenoid Sinus / pathology