ABSTRACT
A 25-year-old male presented with complaints of sudden diminution of vision with pain on eye movement in the left eye which was diagnosed clinically as retro bulbar optic neuritis. However, magnetic resonance imaging (MRI) showed lesion consistent with sphenoid sinus mucocele. Early surgical removal of mucocele led to complete recovery of vision, contrast and visual field. A high index of suspicion is necessary for intracranial lesions in all cases of retro bulbar neuritis, especially those with atypical symptoms.
Subject(s)
Adult , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Mucocele/diagnosis , Mucocele/surgery , Optic Neuritis/diagnosis , Otorhinolaryngologic Surgical Procedures , Paranasal Sinus Diseases/diagnosis , Paranasal Sinus Diseases/surgery , Sphenoid Sinus , Tomography, X-Ray Computed , Visual AcuityABSTRACT
A sphenoid mucocele often presents late due to its deep seated anatomical site. And it has varied presentation due to its loose relationship to the cavernous sinus and the base of the skull. We describe a case of large sphenoid sinus mucocele. A middle aged old man suddenly developed third cranial nerve palsy. Brain imaging study revealed an isolated sphenoid sinus mucocele, compressing right cavernous sinus. Endoscopic marsupialization of the mucocele via transnasal approach led to complete resolution of the third cranial nerve palsy. Involvement of the third cranial nerve in isolated mucocele is rare but important neurosurgical implications which must be excluded. In addition, proper and timely treatment must be performed to avoid permanent neurologic deficit.
Subject(s)
Humans , Middle Aged , Cavernous Sinus , Mucocele , Neuroimaging , Neurologic Manifestations , Oculomotor Nerve , Oculomotor Nerve Diseases , Paralysis , Skull , Sphenoid SinusABSTRACT
A sphenoid sinus mucocele is a rare condition that causes a variety of symptoms by creating pressure on important contiguous neurological and vascular structures. The lesion is difficult to diagnose due to the subtlety of its symptoms, but careful radiological evaluation, with CT and MRI, for example, can help to provide a correct assessment. Transnasal endoscopic surgery can potentially deliver dramatic reduction in the operative morbidity of surgery for paranasal sinus mucoceles by offering an approach that is minimally invasive under local anesthesia. We experienced a 37-year-old male patient with a large sphenoid sinus mucocele protruding into both nasal cavities. The patient was treated with transnasal endoscopic marsupialization.
Subject(s)
Adult , Humans , Male , Anesthesia, Local , Magnetic Resonance Imaging , Mucocele , Nasal Cavity , Sphenoid SinusABSTRACT
Mucocele of the sphenoid sinus is a rare disease, and its signs and symptoms are different depending on multiple contiguous neurologic and vascular structures. So it is occasionally misdiagnosed as pituitary tumors. But careful radiologic evaluation including CT scan, helps in the correct assessment of this lesion. We have recently experienced one case of sphenoid sinus mucocele which presented with subtle nasal symptom. The mucocele was removed by endoscopic intranasal sphenoethmoidectomy.
Subject(s)
Mucocele , Pituitary Neoplasms , Rare Diseases , Sphenoid Sinus , Tomography, X-Ray ComputedABSTRACT
Mucocele is commonly found in frontal sinus. Mucocele of sphenoid sinus is rare and only 100 cases have been reported since Burg's description in 1889. Their etiology is still conjectural. These lesions are potentially more serious and are often misdiagnosed as pituitary tumor. The author experienced a case of sphenoid sinus mucocele develped headache, fever and CSF rhinorrhea. Plain skull, cisternography brain CT scan help the diagnosis of sphenoid sinus mucocele. A transnasal approach is considered best for case with extensive sphenoid sinus mucocele with bone destruction in the floor of sella turcica. The headache, fever and CSF rhinorrhea improved after surgery.