Isolated Sphenoid Sinus Disease- A Unique Case of Sphenoidal Mucocoele

Main Article Content

Tushar Kanti Ghosh
Srijoy Gupta
Pradeep Devineni

Abstract

Introduction


Isolated Sphenoid Sinusitis and sinus lesions is a rare entity accounting for just 1-3% of all Sinus afflictions. Most have occurred in men between the ages of 30 and 40 years.


Case Report


A case of right sphenoid sinus mucocele is reported in a male patient aged 68 years, with size of the lesion (35 x 34 mm) detected by CT & MRI scans. The patient presented with a 3 weeks history of unilateral ptosis, diplopia, and photophobia. He also complained of bilateral nasal obstruction, nasal stuffiness, and a mucoid nasal discharge. Endoscopic decompression of the right sphenoid sinus was performed, and approximately 160 ml of thick, sterile mucoid secretion was aspirated. Despite the size of the mucocele, no significant destruction of the sphenoid walls was evident. Postoperatively within 15 days the patient's symptoms improved significantly.


Conclusion


The Nasal Endoscope has revolutionised sphenoid sinus mucocele treatment. An adequate sphenoidotomy and drainage give excellent results.

Article Details

How to Cite
1.
Ghosh TK, Gupta S, Devineni P. Isolated Sphenoid Sinus Disease- A Unique Case of Sphenoidal Mucocoele. BJOHNS [Internet]. 2020Jul.28 [cited 2024May19];26(3):234-7. Available from: https://bjohns.in/journal3/index.php/bjohns/article/view/216
Section
Case report
Author Biographies

Tushar Kanti Ghosh, Ghosh ENT Foundation FE 350, Saltlake Sector 3, Near Tank No 12 and GD Market, Saltlake city, Kolkata 700106.

Director & Senior Consultant

Srijoy Gupta, Ghosh ENT Foundation, Saltlake, Kolkata Ph No.+919073464039

Junior Consultant

Pradeep Devineni, Ghosh ENT Foundation, Saltlake, Kolkata

Junior Consultant 

References

Singh D, Sohal BS, Aggarwal S. Isolated Sphenoid Pyocele with Thornwaldt’s Cyst of Nasopharynx. Indian J Otolaryngol Head Neck Surg. 2011; 63(1): 140-1

Thane D, Cody R, Hallberg OE. Pyocele of the Sphenoid Sinus AMA Arch Otolaryngol. 1959; 70(4): 495-9. doi:10.1001/archotol.1959.00730040505011

Ono Y, Ono G, Chigasaki H, Ishii S. Clinical manifestation of muco- and pyocele of the sphenoid and ethmoid sinuses. No Shinkei Geka 1975; 3(8): 681-9

Giovanetti F, Fillaci F, Ramieri V, Ungari C. Isolated sphenoid sinus mucocele: Etiology and management. J Craniofac Surg. 2008; 19(5): 1381-4. doi: 10.1097/SCS.0b013e31818437d6

Kennedy DW, Josephson JS, Zinreich SJ, et al. Endoscopic sinus surgery for mucoceles: A viable alternative. Laryngoscope 1989; 99: 885-95

Skillern RH. The Catarrhal and suppurative diseases of the accessory sinuses of the nose. Ed. 3, Philadelphia, J. B. Lippincott Company, 1920, p. 344. 19

Stammberger H. Functional endoscopic sinus surgery: the Messerklinger technique. Philadelphia: Decker; 1991. p. 208

Khademi B, Gandomi B, Tarzi M. A huge sphenoid sinus mucocele: Report of a case. Ear Nose Throat J. 2009; 88(5): E5

Sundar U, Sharma AL, Yeolekar ME, Pahuja V. Sphenoidal sinus mucocoele presenting as mono-ocular painless loss of vision. Postgrad Med J. 2004; 80(939): 40

Friedman A, Batra P.S, Fakhri S, Citardi MJ, Lanza DC. Isolated Sphenoid Sinus Disease: Etiology and Management. Otolaryngology- Head and Neck Surgery 2004, 133(4):544-50

Friedman G, Harrison S. Mucocoele of the sphenoidal sinus as a cause of recurrent oculomotor nerve palsy. J Neurol Neurosurg Psychiat. 1970, 33, 172-9

Bahgat M, Bahgat Y, Bahgat A. Sphenoid sinus mucocele. BMJ Case Reports. 2012; 2012: bcr2012007130. doi:10.1136/bcr-2012-007130

Bell D, Gaillard F et al. Paranasal Sinus mucocele. https://radiopaedia.org/articles/paranasal-sinus-mucocele.

Fujimoto K, Shimomura T, Okumura Y. A case of Sphenoid sinus mucocele. No Shinkei Geka 1999; 27(12):1129-32

Lee La, Huang CC, Lee TJ. Prolonged visual disturbance secondary to isolated sphenoid sinus disease. Laryngoscope 2004; 114: 986-99

Lee JC, Park SK, Jang DK, Han YM. Isolated Sphenoid Sinus Mucocele Presenting as Third Nerve Palsy. Journal of Korean Neurosurgical Society 2010; 48(4): 360-2. doi:10.3340/jkns.2010.48.4.360

Mograbi AE, Soudry E. Ocular cranial nerve palsies secondary to sphenoid sinusitis. World Journal of Otorhinolaryngology- Head and Neck Surgery 2017; 3(1):49-53. https://doi.org/10.1016/j.wjorl.2017.02.001