A 48-year-old woman visited out-patient clinic of neurology after 2 weeks of headache. The localization of headache was mainly on right side of head. It showed as intermittent dull pain, especially at night. Headache was relieved after taking pain reliever. However, headache occurred again when she stopped taking medicine. The patient visited out-patient clinic of neurology again. There was no abnormal change in brain parenchyma after taking brain CT scan. However, occupying lesion was found in the right sphenoid sinus. This patient was immediately hospitalized in the Otolaryngology Department. Further paranasal sinus CT demonstrated abnormal density of the right sphenoid sinus with calcification and lesion on the sinus wall (Figure ). Patient was treated by transnasal endoscopic sphenoidotomy without antifungal therapy. Histopathological examination diagnosed right sphenoid sinus as SSFB (Figure ). No further recurrence of her headache was found after 14 months follow-up.
A 61-year-old woman visited out-patient clinic of neurology because of 1 year intermittent distending pain on the right occipital, aggravating within 10 days. She received treatment from the community hospital but without relief. There was no positive symptoms in nervous system. CT scan did not show any abnormal alteration in brain parenchyma. It indicated right fungal sphenoid sinusitis. Then, this patient was referred to the Otolaryngology Department. Paranasal sinus CT abnormal intensity of soft tissue in right sphenoid sinus with calcification, bone damage on sinus wall, fungal sphenoid sinusitis. Patient undertook transnasal endoscopic sphenoidotomy without antifungal therapy. Histopathological examination diagnosed right sphenoid sinus as SSFB. Follow-up of 5 months demonstrated no further recurrence of her headache.