Isolated Sphenoid Sinus Mucocele with Occular Symptoms: A Case Series
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CLINICAL REPORT
Isolated Sphenoid Sinus Mucocele with Occular Symptoms: A Case Series Ankit Mishra1 • Dinesh patel1 • Vishal R. Munjal1 • Murli Patidar1
Received: 16 August 2020 / Accepted: 23 September 2020 Ó Association of Otolaryngologists of India 2020
Abstract Mucoceles are benign, encapsulated, expansible, locally invasive masses within a paranasal sinus filled with mucus and lined by epithelium. Sphenoid sinus mucoceles are relatively rare, accounting for only 1% of all paranasal sinus mucoceles. Usually presenting with headache but can rarely result in visual defect, diplopia and at times, ptosis. We present two cases of sphenoid sinus mucocele where patient presented with ophthalmoplegia, ptosis and/or sudden onset vision loss. With the help of imaging studies like CT scan and MRI of paranasal sinus diagnosis was made and immediate surgical intervention was planned which resulted in acceptable improvement of symptoms and vision.
mucocele is not clear, but postulated as the obstruction of the sinus initiates its development. There are other theories about its aetiology, including cystic degeneration of epithelial mucus glands, or cystic degeneration of an inflammatory polyp [1, 2]. Sphenoid sinus mucoceles are relatively rare, accounting for only 1% of all paranasal sinus mucoceles [3, 4]. Usually presenting with headache but can rarely result in visual defect, diplopia and ptosis [5, 6]. In this article, we present two cases of first-episode sphenoid sinusitis with persistent facial numbness, visual and ocular symptoms and point out the importance of early diagnostic imaging and immediate surgical intervention to achieve acceptable improvement of symptoms.
Keywords Sphenoid mucocele Sphenoidotomy Ophthalmoplegia Diplopia
Case 1
Introduction Mucoceles are benign, encapsulated, expansible, locally invasive masses within a paranasal sinus filled with mucus and lined by epithelium. Mucoceles occur in all of the paranasal sinuses but arise most commonly in the frontal sinus. Isolated sphenoid sinus mucocele is rare in paranasal sinus mucoceles. The mechanism in the development of
& Ankit Mishra [email protected] & Vishal R. Munjal [email protected] 1
Department of Otorhinolaryngology and Head and Neck Surgery, Sri Aurobindo Medical College and Post Graduate Institute, Sanwer Road, Indore, M.P 453555, India
43-year female patient presented with complaints of persistent left side unilateral headache for 1 year, numbness over left side of face since 3 months, progressive diminution of vision in left eye since 7 days these complaints were associated with left retro orbital pain and nasal blockage occasionally. There was no complaint of hyposmia, post nasal drainage or any other co-morbid illness like diabetes mellitus or hypertension etc. On nasal endoscopy nasal mucosa was mildly congested and small amount of mucoid discharge was present in both nasal cavities. Extraocular muscle movement was normal in all direction and vision was 6/9 in right eye while in left eye she was able to perfor
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