Paranasal sinus mucocele is a mostly benign disease but can cause irreversible complications depending on its location. A sphenoethmoidal mucocele (SEM) can cause compressive neuropathy due to its proximity to the optic nerve. Urgent endoscopic marsupialization is considered the treatment of choice for SEM. However, there is a scarcity regarding recurrence or operative size. Herein, the authors report a case of SEM that recurred after small endoscopic drainage. The patient was reoperated with wide cyst removal and nasal cavity ventilation expansion. Vision was partially resolved, and no recurrence was reported in the 6-month follow-up period.
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http://dx.doi.org/10.1097/SCS.0000000000007825 | DOI Listing |
Brain Spine
September 2023
Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico C. Besta, Milan, Italy.
Background: Meningoencephalocele is defined as an abnormal sac of brain tissue and meninges extending beyond natural skull margins, often leading to cerebrospinal fluid (CSF) leakage. When this condition arises in the spheno-ethmoidal region, the diagnosis becomes more challenging as it can be mistaken for other nasal pathologies, such as mucocele.
Research Question: We show in this case report a non-congenital sphenoethmoidal meningoencephalocele causing rhinoliquoral fistula and spontaneous intracranial hypotension.
Ear Nose Throat J
November 2023
Department of Otorhinolaryngology-Head and Neck Surgery, Inha University Hospital, Inha University School of Medicine, Incheon, Korea.
In a patient whose sudden vision loss is suspected on the side of a previously operated sphenoid or ethmoid sinus, an ischemic insult to the optic nerve may occur due to a compressing mucocele, especially when there is bony dehiscence of the orbital apex. We report a case of a 41-year-old healthy male patient who had a history of previous sinus surgery, and visited the emergency department for an abrupt left ocular pain following visual loss of the affected eye. The patient's left eye's best corrected visual acuity (BCVA) was hand motions with a reduced light reflex.
View Article and Find Full Text PDFIndian J Otolaryngol Head Neck Surg
October 2022
Department of Otorhinolaryngology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, 110029 India.
A mucocele of a paranasal sinus is a mucus filled cystic mass lined by epithelium filling the involved sinus whose ostium is obstructed. While frontoethmoidal mucoceles are common, Onodi cell mucoceles are less frequently seen. Due to its anatomic proximity to optic nerve, it can lead to devastating visual complications.
View Article and Find Full Text PDFJ Craniofac Surg
October 2021
Department of Otorhinolaryngology-Head and Neck Surgery, Konyang University College of Medicine, Daejeon, South Korea.
Paranasal sinus mucocele is a mostly benign disease but can cause irreversible complications depending on its location. A sphenoethmoidal mucocele (SEM) can cause compressive neuropathy due to its proximity to the optic nerve. Urgent endoscopic marsupialization is considered the treatment of choice for SEM.
View Article and Find Full Text PDFJ Neuroophthalmol
December 2020
Departments of Ophthalmology and Visual Sciences (Kellogg Eye Center) (EW), Otolaryngology (ELM), Pathology (Neuropathology) (SC-P), Radiology (Neuroradiology) (HAP), Neurosurgery (ELM, JDT); and Neurology (JDT), University of Michigan, Ann Arbor, Michigan.
Background: Allergic fungal rhinosinusitis (AFRS) is a common condition in which sinusitis develops as an IgE-mediated response to common sinonasal fungal organisms. If that response leads to blockage of sinus ostia, bone expansion and erosion by expansive cysts containing dense inspissated debris may occur with the potential for critical neurovascular compression including damage to the anterior visual pathway.
Methods: Review of clinical and imaging features of 2 patients who sustained catastrophic clinical outcomes.
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