ABSTRACT
OBJECTIVES: To define a diagnostic strategy of a sphenoid sinus lesion and the management of CSF fluid leak in the case of a sphenoid arachnoidocele. MATERIALS AND METHODS: A 70-year-old woman exhibited a sphenoidal sinus opacity which was discovered on the assessment of chronic headaches. It was labelled sphenoid mucocele. A cerebrospinal fluid leak occurred when the marsupialization was made. After an assessment of additional imaging (MRI, CTscan), the diagnosis of sphenoid arachnoidocele was retained. RESULTS: The leak was repaired by navigated endoscopic endonasal surgery. We used a multilayer reconstructive technique with autologous materials (abdominal fat, fascia of muscle, middle turbinate) and fibrin glue. With a decline of eighteen months no rhinorrhea was noted. CONCLUSION: Sphenoid arachnoidocele is a rare disease. This case shows that it's essential to know the differential diagnosis sphenoid sinus lesions and how to repair an osteomeningeal leak.
Subject(s)
Meningocele/diagnosis , Aged , Cerebrospinal Fluid Rhinorrhea/etiology , Female , Headache Disorders/etiology , Humans , Magnetic Resonance Imaging , Meningocele/surgery , Sphenoid Sinus , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: The aim of this study is to report our experience of causes of newborn and infant nasal obstruction. METHODS: Four cases (3 newborns, 1 infant) of nasal dyspnea are reported. For each of them, background circumstances, diagnostic and therapeutic methods and outcomes are reported. Based on a review of the literature, the main causes of nasal obstruction and their treatments are discussed. RESULTS: In all cases, the diagnosis was made by the rhinoscopy with an endoscope and CT-Scan. Choanal atresia, infectious rhinitis, bilateral lacrymo-nasal cyst and nasopharyngeal hamartoma were diagnosed, and associated with respiratory distresses or difficulties in feeding. The treatment consisted of simple removal of the nasopharyngeal hamartoma, marsupialization for the lacrymo-nasal cysts, antibiotherapy and stenting for a few weeks for the infectious rhinitis and permeabilization by puncture and stenting for the choanal atresia. The outcome was successful in all cases. CONCLUSION: Newborn and infant nasal dyspnea is a serious disease. This study underlines the importance of efficient and rapid management. Knowledge of the possible causes grouped in three categories--malformative, tumoral and infectious--is mandatory to make the appropriate choice.
