Sphenoid sinusitis: Causes, symptoms, treatment, and prevention

sphenoid sinusitisSphenoid sinusitis is an inflammation-related condition that can create uncomfortable symptoms and headache pain. Here, we explore what causes sphenoid sinusitis and how to deal with it.

Our sinus is a cavity filled with air on both sides of our nasal structure. The cavities filter the air we inhale with the assistance of the lining of mucus our nasal cavity contains. There are actually four sinuses around the nasal cavity and at the back of the head; right behind our eye is the sphenoid sinus.


Having sphenoid sinusitis means that you have inflammation in sphenoid sinuses.

Causes of sphenoid sinusitis

The main cause of sphenoid sinusitis is a bacterial infection. The infection is centered in the sphenoid sinus. Aside from bacteria, fungus, allergens, and viruses can contribute to sphenoidal sinus.

The bacteria that is most often responsible for inflammation and sphenoid sinus infection is Streptococcus pneumonia. The viral infection Haemophilus influenza can also spurn sphenoidal sinus pain. These microbes cause excessive mucus in the sinus and block the nasal cavity.

When these types of infections become too active, they can be hard to treat. There are some people who suffer from chronic cases of sphenoid sinusitis. Some doctors refer to this as sphenoidal sinus disease.

Symptoms of sphenoid sinusitis

Sphenoidal sinusitis symptoms can feel the same as other types of sinusitis, but many doctors suggest that it is more serious, especially if it is not treated properly. The progression of sphenoid sinusitis can lead to neurological damage.

Here are some of the typical sphenoidal sinusitis symptoms:

  • Mucus discharge – post nasal drip and sore throat
  • Headache – pain on top of head and around temples
  • Neck pain – sometimes including ear pain as well
  • Weakened sense of smell – due to mucus build-up
  • Pressure and pain around eyes – often accompanied by headache
  • Chills – often with fever and fatigue
  • Cough and bad breath – common in chronic cases
  • Swollen eyes – often with constant watering
  • Nasal bleeding – something that requires immediate attention

The sphenoid is one of the most sensitive of the sinuses due to the connection to the optic nerve. This is one of the reasons sphenoid sinus headache is so common in those who contract this type of infection.

Pathophysiology of sphenoid sinusitis

The pain and symptoms are understandable when you look at the pathophysiology of sphenoid sinusitis.

Many people who suffer from sphenoid sinusitis also suffer from upper respiratory infection. The pain is caused by increased pressure from elevated oxygen absorption into blood vessels within the mucous membrane. Viral or bacterial infection leads to inflammation and fluid build up, which oozes out from blood vessels due to the negative pressure. Meanwhile, positive pressure on the blood vessels causes swelling and pain. It is the presence of foreign organisms that can trigger a strong inflammatory reaction.

Treatment of sphenoid sinusitis

Sphenoid sinusitis can be treated in one of two ways: surgical and non-surgical.

  • Non-surgical treatment – antibiotics and intranasal corticosteroid, nasal sprays, nasal decongestants, steam inhalation, and analgesics (painkillers).
  • Surgical treatment – procedures that reduce blockage of the sinus and help drain secretions. Drainage can be conducted with endoscopy, which is a small, metal telescope inserted into the nostril. It does not require incisions in the face or mouth. Surgery is more likely in cases of chronic sinusitis.

It is important to keep in mind that overuse of antibiotics can be common in cases of sinusitis and this can lead to other health complications, such as upsetting gut flora and antibiotic resistance. When someone is prescribed an antibiotic, it is usually for a specific period.

Many doctors will monitor a patient’s response to antibiotic treatment three to five days after initial administration to determine if there are any improvements. There are situations where a combination of antibiotics and intranasal corticosteroids is more effective in addressing the infection.

If you think you might be suffering from sphenoid sinusitis, the quicker you receive treatment, the higher the chance you will have of recovering quickly.

Prognosis of sphenoid sinusitis

When sphenoid sinusitis is treated within the span of four weeks, a sufferer can quickly experience relief. For example, sinus headache is one of the biggest complaints from people who have sphenoid sinusitis. With proper treatment though, the majority of headache sufferers experience pain relief within a few days. Using home remedies such as inhaling steam can be good additional treatment. Many people who have used this method say it has been helpful particularly at night when they are trying to sleep and breathing is more difficult.

Complications of sphenoid sinusitis

You can reduce the risk of complications when you seek treatment early. Severe complications can lead to the formation of an abscess in the brain and cranial nerve. Meningitis is also a risk. Antibiotics continue to be recommended in many cases as the medication has a strong track record for decreasing severity of the infection, shortening the infection period, and helping to avoid any complications. Below we outline some of the other potential complications to be mindful of.

  • Cavernous sinus thrombosis – the cavernous sinus cavity draining deoxygenated blood out of the brain undergoes blood clotting.
  • Periorbital cellulitis – inflammation of eyelids and skin or the skin around the eyes.
  • Osteomyelitis – infection of the bones of the nasal cavity.
  • Tumor – formed within the sinus, which has potential to spread to the cavernous sinus.
  • Abducens Nerve Palsy – associated with dysfunction of the cranial nerve. It can impair abduction of the eye, which means eye movement.
  • Protrusion of eyes – the eyes bulge out.

Prevention of sphenoid sinusitis


There are some preventative measures you can take to try to avoid sphenoid sinusitis. Refraining from active and passive smoking, avoiding dry nasal passages by using nasal sprays, and keeping on top of allergic reaction treatment can be helpful.

It is a bit of balancing act because you don’t want your nasal passage to be too wet either as this can create the perfect environment for some microbes to take hold. If your nasal airways are really dry, it can increase the risk of bacterial infections. This can happen in the winter, but humidifiers are a good measure as long as you aren’t standing over them.

Related: Understanding frontal headaches: Causes, symptoms, and treatment tips



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