Anterior Clinoid Mucocele: A Trans-Nasal Endoscopic Approach

Abstract

The goals of the treatment of paranasal sinuses mucocele are the relief of the symptoms due to compression and the prevention of recurrence. Because of the benignity of the pathology, it is mandatory to choose the approach that minimizes the surgical trauma. When an anterior clinoid mucocele is found, the conventional approaches are the trans-nasoethmoidal, the subtemporal or the pterional ones: we think that as a really mini-invasive approach, the transnasal endoscopy may be proposed. Anterior clinoid localization may be reached by a trans-sphenoidal way and treated by endoscopic microsurgery with a very low morbility. This paper deals with a case of anterior clinoid mucocele treated by this way with good anatomic and functional results and stresses the importance of the pre-operative imaging (CT/MR) allowing one to make a sure diagnosis and to choose the cases suitable for this surgical approach.

Complete recovery of acute monocular visual loss following endoscopic resection of anterior clinoid mucocele: Case report and review of the literature

“…Because of their compressive nature, most authors advocate early surgical decompression of the cystic lesion via an endoscopic transnasal approach [11,12,14,15,18,19,22] or a transcranial approach [4,9,10,13,16,17]. A large marsupialization of the mucocele is generally definitive and complete removal of the cyst wall should be performed whenever possible [23].…”

“…Onodi cells are therefore similar to pneumatized anterior clinoid processes in their proximity to the optic nerve and canal, however they are anatomically distinct. Mucoceles involving the anterior clinoid process are particularly rare with only 16 other cases reported in the literature (Table 1) [4][5][6][9][10][11][12][13][14][15][16][17][18][19].…”

“…Patients with mucoceles involving the anterior clinoid process mainly present with orbital symptoms including ipsilateral retroorbital pain and progressive monocular visual loss [4][5][6][9][10][11][12][13][14][15][16][17][18]. The visual disturbance can fluctuate over time and range from complete blindness to a limited visual field defect such as a central scotoma [20].…”

Anterior clinoid mucocele presenting with orbital apex syndrome

“…[1723] Sphenoid sinus mucoceles involving an aerated ACP have been sparsely reported in the past, with the majority presenting with vision loss as the primary complaint. [26791012141519212224] Ophthalmoparesis at presentation has been reported less frequently. [81116] In this report, we describe a spontaneous ACP mucocele presenting as OAS, progressing to cause mass effect upon the ipsilateral optic nerve.…”

Anterior Clinoid Mucocele—Clinical Presentation, Investigations, and Management by Endoscopic Excision: Review of Literature

“…Anterior clinoid localization of a mucocele is exceptionally rare, with only 14 cases reported in the medical literature (►Table 1). [1][2][3][4][5][6][7][8][9][10][11][12][13] We report two cases of anterior clinoid mucocele causing optic neuropathy, which were treated successfully with endoscopic surgical excision through a transnasal transsphenoethmoidal approach.…”