A 50-year-old woman visited out-patient clinic of neurology because of 1 year intermittent sharp pain on the left head and face, aggravating within 15 days. In the past 1 year, headache occurred every day and lasted for 3–4 h, symptom was worse at day time, particularly after bending. There was no nausea and vomiting. Gradually, pain localized on left cheek, accompanying with left superior teeth and eye pain. She was treated with Vitamin B1, Mecobalamin and Carbamazepine, but without relief. There was clear tenderness on the position of left supraorbital nerve and infraorbital nerve. She was preliminarily diagnosed as trigeminal neuralgia and was admitted in the Neurology Department. Enhanced brain MRI showed left sphenoid sinusitis with mucoceles, but without any abnormal alteration in brain parenchyma. Consultation of ENT doctor suggested to perform paranasal sinus CT scan. It demonstrated that left sphenoid sinusitis with abnormal intensity of soft tissue, absorbent thinning of front sinus wall, bone hyperplasia of side and rear sinus wall. Then, this patient was referred to the Otolaryngology Department. Patient was treated by transnasal endoscopic sphenoidotomy without antifungal therapy. Histopathological examination diagnosed left sphenoid sinus as SSFB. No further recurrence of her headache was found after 4 years follow-up.
A 59-year-old woman visited out-patient clinic of neurology because of 3 years intermittent sharp pain on left orbital. She was diagnosed as trigeminal neuralgia in the community hospital. Then, she was treated with Carbamazepine, Mecobalamin and acupuncture, but without significant relief. Our examination found tenderness at the exit of the left supraorbital nerve. MRI imagine demonstrated that partial empty sella and left sphenoid sinus. This patient was referred to the Otolaryngology Department. Paranasal sinus CT demonstrated inflammation of left sphenoid sinus. Patient was treated by transnasal endoscopic sphenoidotomy without antifungal therapy. Histopathological examination diagnosed left sphenoid sinus as SSFB. Follow-up of 2 month demonstrated no further recurrence of her headache.\nAll of the major clinical information in patients with SSFB was summarized in the Table .