A Retrospective Analysis of Spontaneous Sphenoid Sinus Fistula: MR and CT Findings
Prashant G. Shetty
,a,
Manu M. Shroffa,
Girish M. Fatterpekara,
Dushyant V. Sahania and
Milind V. Kirtanea
a From the Departments of Imaging (P.G.S., M.M.S., G.M.F., D.V.S.) and Otolaryngology (M.V.K.), P.D. Hinduja National Hospital and Medical Research Centre, Mumbai, India.
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FIG 1. Patient 11.
A, Coronal high-resolution CT scan, obtained through the sphenoid sinus, shows a defect at the junction of the anterior portion of the lateral wall of the sphenoid sinus on the right side with the floor of the middle cranial fossa (arrow) associated with a meningocele. Note the concave lateral wall on the right side. CSF is seen on both sides of the sphenoid sinuses.
B, Coronal T1-weighted (600/15/2) MR image of the brain clearly depicts brain tissue herniating through the bony defects bilaterally (long arrows). The open arrow points to the CSF in the right sphenoid sinus.
C, Coronal T2-weighted (4600/90/2) MR image of the brain shows herniation of brain tissue (thick arrow) and CSF (arrowhead) bilaterally. Empty sella is also seen (small arrow).
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FIG 2. Patient 10.
A, Coronal high-resolution CT scan, obtained through the sphenoid sinus, shows a defective intersphenoid septum deviated to the left (thick arrow). The long arrow points to the defect in the anterior portion of the lateral wall of the sphenoid sinus on the left side, just inferior to the attachment of the septum. The small arrows depict arachnoid pits.
B, Coronal T1-weighted (600/15/2) MR image of the brain shows brain tissue herniating through the defect (curved arrow) in the anterior portion of the lateral wall of the sphenoid sinus on the left side. The straight arrow shows the defective intersphenoid septum.
C, CT cisternography scan shows the CSF tracking through the defect in the anterior portion of the lateral wall of the left sphenoid sinus into the right side (small arrows). The defective intersphenoid septum (thick arrow) is seen inserted just superior to this defect.
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FIG 3. Patient 5. Coronal high-resolution CT scan, obtained through the sphenoid sinus, shows the presence of a defect in the lateral wall of the sphenoid sinus on the right side through the region of the foramen rotundum (large arrow). The small arrow points to the normal foramen on the left
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