Signs & symptoms of sphenoid sinusitis

Updated July 19, 2017

Sphenoid sinusitis is a frequently misdiagnosed condition. Because the sphenoid sinuses lay hidden within the skull behind the nasopharynx, it can be difficult to identify disease there. Knowing the signs and symptoms may help you determine if a physician should consider the possibility of sphenoid sinusitis. Early detection can prevent more serious complications, which include neurological damage and, rarely, death.

General Symptoms

All sinus infections have some common symptoms, including thick, yellow or green mucous, and a stuffy nose. Less commonly, there may be a sore throat, foul breath, tiredness and a weakened sense of smell. Since the main symptom of any sinus infection is pain, the location of the pain can signal which sinus is affected, states the National Institute of Allergy and Infectious Diseases.


The sphenoid sinuses are located just above the nasopharynx and just below the pituitary gland, behind the ethmoid sinuses. If touching the forehead is painful, you may have inflamed frontal sinuses. If your teeth or upper jaw ache, the likely culprit is an infection in the maxillary sinuses. If the ethmoid sinuses are affected, the pain will be between your eyes with swelling of the lids and surrounding tissues. As the Yonsei Medical Journal states, a pivotal indicator of sphenoid sinusitis is a headache that is transient, located usually behind the eye and, second most commonly, in the front of the head.

Sphenoid Sinusitis

The sphenoid sinuses are less commonly affected than the other sinuses. The National Institute specifically cites earaches, pain at the top of the head and neck pain as indicators. The National Guideline Clearinghouse states that some patients have called a sphenoid sinusitis headache the worst of their lives. Unfortunately, as noted, sinus infections can send pain to many locations, and identifying which sinus is affected is not always easy.


Though sinusitis symptoms can mimic those of a cold, longevity is a good indicator that a sinus is infected. A physician can diagnose one by noting symptoms and examining the nasal tissues. If the diagnosis is not clear-cut, the doctor can order a computed tomography, or CT, scan. The doctor can exclude possibilities by testing nasal secretions for bacterial or fungal infections, ordering a blood or sweat test to check for cystic fibrosis, or taking a biopsy of the nasal membranes.


The reason sphenoid sinusitis is of particular concern is the sphenoid sinuses' proximity to more than a dozen important structures, to include ones related to vision, the internal carotid artery and the cranial nerve. Chronic infections or those lasting for more than 14 days should be brought to a doctor's attention. Keeping notes on symptoms and where pain presents will help your doctor with her diagnosis.

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About the Author

Diane Makar Murphy is a writer with a Bachelor of Arts in journalism from San Jose State University and a Master of Arts in education from Chapman University. Her more than 30 years of writing include articles in the "Atlanta Journal and Constitution," "Youngstown Vindicator" and on various websites. Two of her curriculum guide books are currently listed with the Center for Learning.