TREATMENT OF EMPYEMA OF THE SELLA TURCICA OF SPHENOID ORIGIN

Abstract

OSTEOMYELITIS of the sphenoid sinus though unusual is not rare. Courville and Rosenvald¹in a series of 15,000 consecutive autopsies found this disease present in 22 cases. The immediate cause of death in these cases was meningitis or thrombosis of the cavernous sinus. Most frequently, a combination of the two was found. An acute sinusitis is more apt to result in intracranial extension than a chronic process. Extension from the infected sphenoid sinus may occur in the following manner. First, it may occur by the presence of a congenital defect in the bony wall. A vascular band may persist and escape pneumatization between the presphenoid and the alisphenoid bone, forming a direct intracranial route for extension.² Second, it may occur by way of veins which connect the interior of the sphenoid to the cavernous sinus. Third, latent osteomyelitis of the sphenoid may be reactivated by trauma, with consequent cerebral