Infection of the sphenoid sinus is an uncommon clinical entity frequently misdiagnosed because of its vague symptoms and paucity of clinical findings. We report a case of sphenoid sinus mucocele complicated by retro-orbital pain and ipsilateral optic atrophy. CT scan and MR image revealed a cystic mass lesion of the sphenoid sinus. Bone around the lesion was eroded. The patient underwent transnasal drainage of the cystic mass. We conclude that transnasal drainage is the safest method of treatment of an infectious lesion in and around the sphenoid sinus.
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