The clinical manifestation, evaluation and surgical management of sphenoid sinus mucoceles: a case series and literature review.

Objective: This study was designed to describe clinical manifestation, treatment and outcomes in patients with sphenoid sinus mucocele presenting to Amiralam Hospital, Tehran, Iran.

Methods: A review of 43280 medical records covering a period of 10 years included just 12 patients with sphenoid sinus mucocele presenting to our teaching centre.

Results: The mean age of the patients was 35 years (ranging from 19 to 52 years). Headache was the most frequent symptom in 9 of the 12 patients. Visual disorders were noted in five patients. Two patients underwent external ethmoidectomy accompanied by intranasal sphenoidotomy while transseptal sphenoidotomy was performed for five patients and five patients underwent endoscopic endonasal sphenoidotomy. Wide spectrum antibiotics were given to all the patients for 3 to 5 days in order to prevent any iatrogenic infection. All patients did well after surgery without postoperative complications.

Conclusions: Sphenoid sinus mucocele should be considered in the differential diagnosis of cystic lesions presenting as visual disturbance. Retro-orbital headache with or without visual symptoms is a leading symptom. CT and MRI are essential in the diagnosis of sphenoid disease.