[Sphenoid sinus mucocele of unusual aetiology and location]

C A Righini, Y Darouassi, K Boubagra, S Schmerber, E Reyt
Revue de Laryngologie—Otologie—Rhinologie 2006, 127 (3): 165-70

UNLABELLED: Mucoceles of the sphenoid sinnus are rare. 140 cases have been reported in the literature.

PURPOSES: We review a case and discuss: 1) pathophysiology and diagnosis of mucoceles; 2) etiologies, anatomical variants, clinical manifestations and treatment of sphenoidal mucoceles.

MATERIAL AND METHOD: Case report and literature review.

CASE REPORT: An 18-year-old female, with no past medical history was hospitalized for right fluctuating monocular blindness. MRI and CT scan facilitated the diagnosis of right clinoid mucocele with compression of the optic nerve. Imagery also revealed fibrous dysplasia of the anterior skull base which probably induced the mucocele formation. The mucocele was successfully decompressed during endoscopic sinus surgery. Postoperative course was unremarkable. At four months post surgery there was no recurrence of ophtalmological symptoms.

DISCUSSION-CONCLUSION: The pathophysiology of mucoceles remains uncertain. Diagnosis is based on imagery (CT scan, RMI). Imagery allows accurate location of the mucocele, defines any concomitant pathology and oulines important anatomical structures necessary for safe endoscopic sinus surgery. The association of fibrous dysplasia and an anterior clinoidal mucocele is exceptional. To our knowledge this is the only report in the literature. Ophtalmologic symptoms with a risk of blindness require urgent surgical treatment. Surgery involves decompression, ideally endoscopically.

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