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Sphenoid sinus infection, anyone heard of this?

I've been having occupital headaches and facial tingling.  My doc sent me in for a brain MRI.  Everything was normal, except the radiologist noted "EXTENSIVE sphenoid sinus thickening, lesser in frontal region.  Been taking 2000 mg amoxicillin fro 2 weeks, I still have large amounts of drainage.  I have been reading that these areas of thickening can cause very serious problems if not treated.  I'm a little scared, my next step is a ENT.  My question is Can this cause the problems that I am experiencing?  Should I maybe be on stronger antibiotics? Thank you very much.
37 Responses
Avatar universal
The Sphenoid sinuses are located in the body of the sphenoid bone.  This is located just behind the eyes.  The inflammation of this sinus often is felt as a nagging headache behind the eyes or on the side of the head.  A sinus is an air pocket within a cavity of a bone and has a narrow opening for blood vessels.  These vessels are very very small and blood must pass one cell at a time.  Antibiotics in the body are "cleaned up" by the liver almost faster than it can travel up into the sinus to get rid of any infection or inflammation.  Because of this, antibiotics are given over a period of time instead of just a few days as with "normal" infections/inflammations.  If the medication is not taken long enough, the condition may return again.  Sinus drainage, or post nasal drip is an occurance that happens on a daily basis whether or not you know it is happening.  As long as the drainage is clear and without odor, and doesn't taste sweet, it is considered to be "normal".
Avatar universal
Some sinus infections are difficult to treat, because of what the poster above mentioned.  If symptoms persist, I would go to an ENT.  In the past, I have had wicked sinus infections.  I have been given a shot of some sort of cortisone, or predisone, for inflammation (helped alot) and a continued course of antibiotic therapy.  In my case, my sinus infections were chronic, accompanied with blood and discharge.  They seem to come and go with the years.  Right now, they are gone....good luck to you.
Avatar universal
I have been having weird nauseating pain.  It is centered in the upper soft palate, and radiates down the back of my throat, along my jaw line, and on bad occasions, up into my temple on one side.  It usually only happens once a week, and the pain level varies.  The pain on one occasion was so bad that I thought it had to be a stroke, but then the pain stopped and I had massive relief.  Do you have any idea what could cause this?
Avatar universal
Sounds like some sort of infection or sinusitis. Your sinuses can become over sensitive to allergens, cold air, etc. If you have had a history of sinus trouble, it is more likely that this may be the problem. In any event, get to the doctor as soon as possible. Any condition that may involve the sphenoid sinuses, needs to be addressed as quickly as possible. Delays in diagnosis of problems related to this area can have devastating complications. God bless you.
Avatar universal
A couple of years ago my boyfriend experienced a random incident of severe dizzyness accomponied by continuous vommiting, He was taken to the emergency room where they treated him for his present symptoms and following he underwent many tests, MRI's, catscans, etc. He was an avid scuba diver so there were also many examinations and tests to find out if it was dive related. He was labled extremely healthy and the wrote off his condition as migranes. He was perscribed medication that helped for a short period of time but he still experienced constant fogginess and a more accute dizzyness. Basically he felt sick every day rather than a few times a month. He stopped taking the meds and immediately felt better. About a month later his previous symptoms returned. He also began to get sick more often. Now it has effected his entire life. It is worse when he exercises, swims, or is in the heat. He is always tired, has a constant nagging headache, he complaines of an irritating feeling deep in his ear, and experiences what seems to me like connstant severe post nasal drip. The most effective treatment he has had yet was one perscribed by a doctor for a sinus inffection, however it only worked for a short period of time again. His condition is standing in the way of everything he loves about life so I have recently committed myself to research. Any suggestions, helpful research tips, reccommendations for great ENT's in the southern California area, would all be really appreciated.
Avatar universal
For those of you looking for an ENT specialist in Southern California I have a great recommendation. Dr. Shawn Nasseri is a fine Otolaryngologist (short for ENT — or ear, nose & throat specialist) and besides being a great physician is one of the nicest human beings I have ever met.
He is an expert in treating sinus problems — also any voice, throat, ear, nose, etc problems. His office is located at 436 N. Bedford Drive in Beverly Hills, CA. Dr. Nasseri treats many of the singers and actors in Hollywood but he is great with all of the patients who are lucky enough to have him for a doctor.
Two members of my family have severe sinus problems related to a rare type of vasculitis (an autoimmune disease) and he has been treating then for over 5 years.
Avatar universal
I'm in my fifth month of chronic headaches on my right side.  In this time I've been treated for a chronic ear infection which did not respond to antibiotic.  I've been told my ears look fine, but am still experiencing discomfort.  With this, I have severe neck pain with swollen lymph nodes and ear pain.  I've been to several doctors, including an ENT twice.  He said my sinuses looked awful, but were not infected and did not make any correlation between them and my symptoms.  He dismissed them as some sort of injury that I'm not aware of.  Last week I went to Urgent Care where I was told I had a pocket of nasty mucous in my left side.  I was given a potent 5-day antibiotic and a steriod.  After two days, I'm not feeling much better.  I wake up thinking I'm better, but by mid-afternoon am miserable.  Could this be my sphenoid sinuses, or something more serious like a tumor.  I'm having a hard time finding a doctor who cares to remedy the problem.
719399 tn?1233456663
My Friends, (male - 35)

I Live in Alberta Canada, Mid July of this year 2008, I had my wife rush me to emergency with numbness in the entire left side of my face, toungue, and possibly (as I was in a panic) left side of my body - arm and weakness in the legs. I thought I was having a stroke, and didnt even know what a TIA was until then. And my heart rate was through the roof. Though all these things were ruled out at emerg, I later had to fight that week to get another doc to send me for CT. they found a questionable area on CT and then nothing on MRI. They wrote it off to anxiety. Though I had 2 - 3 more significant ocaisions of tingling / numbness on the top left of the scalp, both sides of the nose, and maxilary areas. rarely, this is also on the right side of the face as well. I've seen a neuro twice - relfexes look good n he's not too worried. My typing and left hand function over the last year has been sub-par. Reading about potentially serious complications from sphenoid sinuses really has me wondering (such as blood clotting). I have been on high blood pressure meds for about a 1/2 a year also, the doc refuses to buy in that Micardis may cause some of these unusual sensations or symptoms, despite what I have read in forums. Any takers? to date, still have some left side facial numbness and throat feels like its trying to close on ocaision to the extent where I have to swallow hard and several times to avoid gaging, just while about daily activities.
719399 tn?1233456663
regarding my previous blurb - the doc did prescribe baby asprin once a day, and that has seemed to help quite a bit. Anyone who has been discussing strokes or blood pressure issues with their doc should also try to get their support on this recommendation. I also forgot to mention the vertigo and nausea that I suffer. Alot of these symptoms can easily be complicated with TMJ (a jaw disorder), now that I have confused the hell out of everyone. But you do have to be persistent with doctors folks - take charge of your health. I thank you all for reading and for any support and input. Happy Holidays.
Avatar universal
Years ago, I was suffering from terrible sinus headaches and sinus infections all the time. No medicine helped me, and a friend of mine took me to her chinise Accupuncturist doctor. He put me 2 times a week to have accupuncture with electricity, and gave me some natural herbal teas from china. and everything dissapeared like magic. No more headaches, no more nausau, no more back or neck pains, no more sinus infections for more than 10 years. Now the headaches, infections, dizziness, nauseas are back. I tried getting in touch with my chinise Accupuncturist doctor, but, he went back to China. Now I'm looking for a nother chinise Accupuncturist in the NYC area to get back into those treatments that helped me so much, because I'm sick of taking antibiotics that don't help at all, and my condition is getting worse, like it was 10 years ago. So I recommend to all of you here suffering from Chronic Sinus infections, to find yourselves a good chinise Accupunturist doctor and go at least 2 times a week. You wont be sorry.
Avatar universal
I have been feeling a bit bla for quit some time now, always having ear pain and swollen glands yet when I went to my ENT no infection, a time or two i did have fluid on the ears. Last Tue I was driving and started seeing spots or shadows behind my eyes. Within minuets I was totally sick to my stomach and could not respond very well. I was rushed to the hospital. I couldn't answer questions correctly the nurses were asking me. I had NO headache pain nor any sinus systems.They told me I had either had a stroke or migraines. I was transferred to a larger hospital, had 2 CT scans a CTA scan and a MRI....well the MRI showed I had a severe case of Sphenoid Sinusitis.I had so many weird systems ( dizziness, confusion,one eye dilated other wasn't, very blurred vision ) all the nurses and Dr's were baffled.They started me on IV drip with heavy antibiotics 4 times a day for two days then Augmentin 875 mg in pill form 2 times a day for 2 weeks, also have Mucinex and Flonase. I am 2 days into my pills and have VERY heavy drainage! I now have the headaches and laying down makes them worse.Once the meds started working, my nose went numb a time or two,the headaches began,a cough began,and I can feel the sinus draining ALL the time! All I can say is research research research, this is a very dangerous thing and can lead to permanent damage!
Avatar universal
I am looking for relief. I have had severe headaches, dizziness and trouble focussing my eyes (intermittent) for more than ten years. An MRI ten years ago showed “small amounts of focal mucousal thickening in the sphenoid sinuses anteriorly, the ethmoid air cells, and the right frontal sinus”. Most recent MRI stated “There is an air fluid level seen within the right sphenoid sinus with associated inflammatory change seen within the ethmoid air cells. Mucousal thickening is seen in the ethmoid air cells. The finding within the sphenoid sinus suggests acute sinusitis.”  I have done antibiotics, netti pot, nasal sprays, etc. Nothing works. Any suggestions?
Avatar universal
I have suffered from chronic sinusitis for 25 years. It took a doc three years ago thinking I was having an aneurism to find the problem on an MRI. These infections in the sphenoid are very rare and most MDs and ENTS do not recommend the sugery because it is a risky surgery, as the wall if the sphenoid is literally
millimeter away from the brain. I know it is coming on by green discharge(very slight until it is almost over and the worst headache when.I bend over, bear down with a bowel movement, and when advanced, the movement of chewing is unbearable and blinking my eyes is painful. I get fever and systemic symptoms like the flu too. As I age, I also now get reactive arthrits and all my joints swell and are painful....just in reaction to the infection. So those of you who KNOW it is sinus, but dogs say no because you have no extreme drainage and no facial pain, persevere. I finally have an MD that trusts me when I come in at the start so I can avoid wishing I was dead than deal with the strange smell in my nose, a crackling sound/feeling near my left eye and the can't bend down headache. I get a long term dose of bactrim (allergic to augmenten), prednisone and relief in about three days. So, find the right doc, get a sinus ct or MRI WHEN you have symptoms, and keep a copyof your tests so you can show the doc. Good luck, these are a pain to deal with.
Avatar universal
I have always gotten nasty chronic sinus infections.  In September 2009, I started having problems with swallowing food (the reflex would stop working mid swallow and I would choke), migraines started happening frequently, my blood pressure would sky rocket upwards of 190/130 (normally 110/72), symptoms of Raynaud's syndrome and I was lethargic and sick.  I was treated for bacterial sinus infection and bacterial kidney infection.  After being rushed to the emergency room with a migraine that felt like an aneurysm my doctor ordered an MRI on my brain and they found that I had a sphenoid sinus infection.  I was immediately sent to an ENT for evaluation.  Upon the consultation with one of the best ENT's in the country located in Texas (******.net is their website and any of these doctors are fantastic!!! They come highly recommended by everyone in the metroplex). It was found that I had serious sphenoid sinus infection that has probably been there for years but was kept at bay due to treatment of my chronic regular sinus infections.  Due to the new affects I was having I was scheduled for an emergency sinus surgery (sphenoid and frontal sinuses).  While he was in there he widen the passages of all the other sinus if he felt it was needed to avoid further surgeries in the future.  Since this surgery (after about 2 months of healing completely) all the symptoms described previously have disappeared and I have never felt better.  Even when the weather changes my sinuses do not swell to the point of irritation to cause an infection.  I have had one sinus infection which was very mild considering what I am use to.  I highly recommend having surgery if it is recommended to avoid unnecessary suffering and pain.  And if you are ever in TEXAS I highly recommend any of the from the ******.net.  
1 Comments
Where in texas
Avatar universal
I was disagnosed with a sphenoid infection 5 years ago.  I've had to undergo 4 surgeries to finally get the infection fully drained; the last surgery was a year and a half ago.  The last surgery was quite a scare, the sphenoid cavity was bulging and about to burst.  Because of this bulge, there has been a tremendous amount of nerve damage around the sphenoid area.  I still suffer with headaches, the nerves tingle out of control and then eventually pain sets in where the nerves were excited and tingling.  I am on various medications and the latest diagnosis was it may or may not repair itself.  It seems here lately the symptoms have gotten worse, my eye twitches uncontrollably, the feet tingle, weather patterns wreck havoc on my head and my memory seems to be slipping every now and then.  i'm 29 years old.  I'm just curious if anyone is familiar with any of these side effects and knowing my history, if I should be concerned that there isn't anything else happening in my neuro system besides nerve damage.
Avatar universal
I am a PhD microbiologist researcher and have been suffering from sphenoid sinus disease from an injury for one year.  It is VERY difficult to find even an ears nost and throat specialist who has expertise in this area.  The peer reviewed medical literature (to which most people do not have access) indicate that it is very important to have intraveinous (IV) antibiotics for 14 days not just two.  In addition, they need to be the type of antibiotic that crosses the blood brain barrier.  Infection of the sphenoid sinus can spread to the brain including the hypothalamus and pituitary, optic nerve, etc.  There are 13 critical structures immediately adjacent to the sphnoid sinuses.  Fungus can also infect the sphenoid sinus and the IV drug needs to be specific for this as well.  You are correct that this is a very serious infection and it is only made worse by the lack of expertise by our physicians.
Avatar universal
Unfortunately, many ENTs want to do surgery first.  I do not know if this is because they get more money for the surgery than for ordering IV antibiotics that cross the blood brain barrier or what.  Did you receive any IV therapy?  If your ENT did not give you antibiotic or anti fungal therapy (did they do cultures to see what was causing your infection?), then the infection can come back even after an extended period of time.  See my previous post.  Many times the infection spreads to other important area of the brain so just "draining" the sphenoid sinus, especially in a case as serious as yours, will not take care of all the infection.
Avatar universal
Thank you for your post.  I finally feel like I've been given both professional and personal information.  I only had my cat scan a few hours ago.  I've been in severe pain for six days now.  I felt like i was beaten with a bat at the base of my skull!  During the night I have to move my head with my hands.  I couldn't move!  I had to drink from a straw and the pain of swallowing was unbearable.  I have awful body aches.  So here I am today hearing my doctor tell me about the sphenoid.  He prescribed actiq but insurance wants precert of some kind so I just took a dilaudid (rx said 1or2) and it didn't help so I took the second and it took the edge off the pain.  I've never had any kind of sinus/nasal issue ever and I'm 53.  I personally think looking back now this has been coming on for about a month or two.  I'd been waking up unable to breath from my mouth or nose and had to "clear my throat" so to speak.  Then 2 days before the sudden "hit with a baseball bat" issue I was to an ENT and diagnosed with Labrythinitis.  This is just awful and wants to be debillitating!  Stress or just a fluke of things going on?!  I thought for sure they were going to throw me the old garbage pail diagnosis ... Fibromyalgia!  I don't know where this is going but I suppose I will visit here for more input.  I hope everyone gets the relief they are looking for ...   :)
Avatar universal
Thank you so much for your post.... I had scans yesterday at UTMB  because of sputum with black threads (since 05) and migraines.  I won't have results until some time next week, as they are also doing a sputum culture.  As my dad's main caregiver, I was exposed to high levels of black toxic mold (aspergillus/penicillium) at his house.  We weren't aware his house had mold until we moved him into a home.  He is diabetic (poorly controlled) and has dementia now. When he was in the hospital, I saw his sputum and it also had black threads.  After that, Dad and I went  to an ENT doctor in Houston, but they only did one scan and found nothing.  A nurse told me the only allergy doctors that check for aspergillus are Texas Childrens and UTMB.   If  they find something hopefully, the "power trippers" in my family will allow Dad to go. From doing research, I've found that fungus can get into the brain through the sphenoid sinus and cause dementia. Will Amphotercin B cross the blood brain barrier?  Has dementia ever been reversed after amphotercin B?    
Avatar universal
Great input here...tx so much!!. After a yr of strange pressure pains in rt temple/top/back of head, twice accompanied by external ear infections, am finally seeing ENT. Brain MRI of 10/10 stated "some mucosal thickening and/or small air fluid level in the posterior right ethmoid air cell and/or adjacent portion of the rt sphenoid sinus." ENT says my ESR & CRP blood levels (inflammatory markers) are fine, so isn't overly concerned. He can't explain pain and speculated about Temporal Arteritis though blood doesn't corroborate. Have been on CPAP w/water for 3 yrs now.....have had sporadic clear nasal drip....wondering if CPAP could be causing infection of Spenoid?  Advised ENT I was seeing holistic dentist for CT scan of jaw to rule out dental sources of bacteria, ie. root canal etc which can invade other areas in body.  He asked me to have dentist include my sinuses in scan if possible. If not, will ask ENT for CT scan of sinuses. I'm fairly holistic in approach to health, so idea of IV antibiotics scares me (have friend whose kidney was destroyed that way). Am presently using Chinese herbs for inflammation and about to try using Grapefruit Seed extract in Netti pot to induce drainage.....just trying to keep it under control pending diagnosis as I fear serious consequences if undiagnosed too long. Has anyone else had Sphenoid issues while using CPAP?    
Avatar universal
My dad was recently diagnosed with Steno and with CT Scans done recently it showed it has spread into his brain. His was found after sinus surgery and has been on 3 different oral antibiotics. He goes this week for IV treatment in hopes it will help. My dad has lost his sense of taste,smell and lost some vision in his right eye. Not sure if its from a botched surgery or from Steno. We are worried as we don't know what the chances are for him as it is now in the brain. Do you have any insight to this?
Avatar universal
Was having seizure and flu like symptoms. Went for an MRI and it showed Chronic Sphenoid and Maxillary Sinus disease. Antibiotics did nothing after 3 days and then my doctor recommend Fluconazole if it was fungal. Within 15 minutes of taking the medication it felt like my face was caving in near the nose and eyes and the sinuses started opening up. After taking Fluconazole for 3 weeks I have not had my sinus infection come back. A recent MRI showed that the sinuses have improved significantly leading me to believe that fungus needs to be looked at for sinus infections not just bacteria.

Fluconazole can be hard on the liver so make sure to get liver function tests done before and during treatment.

I did go off the medication after 3 weeks because I was having some major effects with my digestive system, probably due to more fungal issues.
Avatar universal
I too am suffering with stephenoid have always used holistic approach but I let this get out of hand after 5 months finally when to doctor gave me 10 day supply of antibiotics which helped but has not cleared it up entirely.  I haven't had antibiotics in over 30 years and I really don't want to take another round. Looks like stephenoid issues can be from bacteria or fungus. Has anyone had any success yet or recommendations?



Avatar universal
I too am suffering with stephenoid have always used holistic approach but I let this get out of hand after 5 months finally when to doctor gave me 10 day supply of antibiotics which helped but has not cleared it up entirely.  I haven't had antibiotics in over 30 years and I really don't want to take another round. Looks like stephenoid issues can be from bacteria or fungus. Have you had any success yet?



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