Isolated sphenoid inflammatory disease is a rare clinical condition among patients with paranasal sinus disease, reported incidence between 1%-3%. 1 The most common symptoms of isolated sphenoid inflammatory lesions are headache, ophtalmological and nasal symptoms. Delayed diagnosis may occur due to its nonspecific symptoms. 2 The disease requires appropriate and good imaging technique for diagnosis. The aim of the study to discuss different pathologies of isolated sphenoid inflammatory

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... Patients and methods: From 2008 to 2017, we performed surgery on 27 patients with isolated sphenoid inflammatory disease. The presenting signs and symptoms, radiological studies, operative findings, and clinical outcomes were retrospectively reviewed and analyzed. Results: 27 cases were identified at tertiary hospital of King Fahad Specialist Hospital Dammam. 12 bacterial sphenoid sinusitis, 4 allergic fungal sinusitis, 4 fungal balls, 2 invasive fungal sinusitis, 3 pediatric (2 sphenoid sinusitis and 1 allergic fungal sinusitis), 1 mucocele, 1 mucopyocele. Conclusion: Isolated sphenoid inflammatory disease is rare, with comprehensive history taking, complete physical examination, appropriate endoscopic examination and advanced imaging studies will give appropriate clinical diagnosis. Histopathology and microbiology are important for definite diagnosis.