The Journal of Laryngology & Otology

Clinical Records

Acute sphenoid sinusitis leading to contralateral cavernous sinus thrombosis: a case report

S R Dyera1, P J Thottama1 c1, S Saraiyaa1 and M Hauperta1

a1 Department of Otolaryngology – Head/Neck Surgery and Facial Plastic Surgery, Children's Hospital of Michigan, Michigan, USA


Introduction: The objective of this article was to report a case of isolated, acute, right-sided sphenoid sinusitis that progressed to contralateral cavernous sinus thrombosis in an 18-year-old male patient. We describe the atypical presentation of this case and discuss the relevant anatomy, pathogenesis, presentation, diagnostic evaluation and treatment.

Case report: A case report of sphenoid sinusitis leading to contralateral cavernous sinus thrombosis was reviewed and presented along with a comprehensive literature review of the relevant anatomy, pathophysiology, microbiology, diagnostic work-up and treatment options.

Conclusion: Cavernous sinus thrombosis is a rare clinical entity in the antibiotic era. However, limited sphenoid sinusitis may progress to cavernous sinus thrombosis in spite of maximal medical treatment, as highlighted in this case report. The mainstay of treatment includes early diagnosis allowing aggressive intravenous antibiotics and appropriate surgical management.

(Accepted November 13 2012)

(Online publication July 24 2013)

Key words

  • Cavernous Sinus Thrombosis;
  • Sphenoid Sinusitis;
  • Ophthalmoplegia;
  • Paranasal Sinus Diseases;
  • Intracranial;
  • Complications


c1 Address for correspondence: Dr P J Thottam, Department of Otolaryngology – Head and Neck Surgery, Children's Hospital of Michigan, 1005 Michigan Catalpa Drive, Royal Oak, Detroit, Michigan USA, 48067 Fax: +1 313 745 5848 E-mail:


  Dr P J Thottam takes responsibility for the integrity of the content of the paper

Competing interests: None declared