Sphenoid sinus mucoceles

Abstract

<p class="abstract"><strong>Background:</strong> Mucoceles are cyst-like lesions lined with respiratory epithelium that most commonly produce bone destruction within the paranasal sinuses. The spread of mucoceles is variable; hence they may cause different symptoms. In a majority of patients, mucoceles involve the frontal sinuses and the ethmoidal labyrinth. Sphenoidal mucoceles are rare and have an incidence of 1%. Prompt management of sphenoidal mucoceles is recommended in order to avoid potentially devastating complications. Our objective was to analyze the various presenting symptoms & signs of sphenoid mucoceles in twelve patients and the outcomes of management.</p><p class="abstract"><strong>Methods:</strong> Twelve patients were diagnosed with sphenoidal mucocele over an 18 year period (January 1998 - December 2015). All patients underwent diagnostic nasal endoscopy, CT / MRI scans prior to management. </p><p class="abstract"><strong>Results:</strong> Twelve<strong> </strong>patients with sphenoid mucocele presented with variable signs & symptoms to a tertiary ENT care facility.<strong> </strong>All patients were successfully managed by endoscopic sinus surgery. Two out of three patients with diminished vision had complete recovery of vision after the procedure. One patient with complete loss of vision had no recovery after endoscopic sinus surgery.</p><p><strong>Conclusions:</strong> Imaging<strong> </strong>plays a vital role in diagnosis of sphenoid mucoceles.<strong> </strong>The close proximity of the optic nerve to the sphenoid sinus makes it very vulnerable to get involved. Early<strong> </strong>diagnosis and management of sphenoid mucoceles<strong> </strong>is crucial. </p>

Sphenoid sinus aspergilloma clinically mimicking as malignancy—a case report

“…The radiological diagnosis in our case was made due to the CT density and signal intensity on MRI despite the lesion was mimicking as mass. Hydrated mucoceles appear hypodense while with increased protein concentration as time progresses result in increased attenuation on CT as in our case [4,5]. The lesion was hyperintense on T1 and hypointense on T2-weighted images (WI).…”

“…The outer bony walls may also get eroded leading to compression over surrounding structures. They are most common in frontal and ethmoid sinuses and least common in sphenoid sinus [4]. The incidence of sphenoid sinus mucocele is less than 1% among all sinuses.…”

“…The incidence of sphenoid sinus mucocele is less than 1% among all sinuses. Due to their expansile nature, sphenoid mucocele can result in headache, ophthalmic disorders, and sellar extension [4].…”

“…In our case, there was extension of lesion into sella turcica with pituitary gland not visualized separately likely markedly compressed. Fungal mucoceles can be expansile and erode or compress adjacent structures [4]. Based on history of headache and bilateral visual disturbance with rapid progression, possibility of malignancy of pituitary region/sphenoid sinus with involvement of optic chiasma or bilateral orbital apex was considered.…”

The Need for Surgery of Isolated Sphenoid Sinus Disease Care Based on Imaging Findings

“…One theory regarding the cause of the mucocele is mechanical obstruction of the sinus, and 7 out of 11 (63.6%) patients with mucocele had a past history of paranasal sinus surgery, which could have caused a mechanical obstruction. Mucocele can progress slowly and asymptomatically until bone erosion or compression affects adjacent structures [15,16]. Detection of ISSD is di cult by conventional X-ray examination, but recent advances in the availability and accuracy of radiological studies have made it much easier to detect ISSD.…”