Isolated Sphenoid Sinus Mucocele with Occular Symptoms: A Case Series

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.

Keywords: Diplopia; Ophthalmoplegia; Sphenoid mucocele; Sphenoidotomy.

Fig. 1

a Saggital section, b axial section of CT scan of para nasal sinuses showing inflammatory mucosal thickening in the left sphenoid sinus, with irregularity and sclerosis in the bony wall

Fig. 2

a Pre-operative image showing right ptosis. b Post-operative day 2. c 2 week follow-up images showing significant improvement

Fig. 3

Non-enhancing T2-hyperintensity lesion completely filling and expanding the sphenoid sinus with mild elevation of sella turcica

Fig. 4

Endoscopic view after Marsupialization of sphenoid sinus mucocele