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Isolated Sphenoid Fungal Sinusitis With Mucocele Mistaken for Chordoma: A Study of Two Unique Cases.

J Rhinol

March 2024

Department of Otorhinolaryngology-Head and Neck Surgery, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.

Isolated sphenoid fungal sinusitis (ISFS) is a rare condition characterized by fungal infection of the sphenoid sinus. It often presents with non-specific symptoms, which can lead to misdiagnosis. This study presents two unique cases of ISFS with mucocele that were initially misdiagnosed as chordoma based on preoperative radiographic findings.

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Background: Isolated sphenoid sinus fungal mucoceles are extremely rare and potentially associated with visual disturbances, cranial nerve (CN) deficits, or pituitary dysfunction. Their initial symptoms are often absent or nonspecific, and routine examination offers little information, resulting in diagnostic and therapeutic delays. A high index of suspicion and a thorough understanding of their clinical presentation, neuroradiological features, microbiological implications, and complication profile are crucial for early diagnosis and prompt management.

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Sudden Blindness as the Only Symptom Caused by a Small Sphenoid Sinus Mucocele in a Young Child.

Ear Nose Throat J

October 2024

Department of Otolaryngology-Head & Neck Surgery, The Second Hospital, Shanxi Medical University, Taiyuan, Shanxi Province, China.

Article Synopsis
  • - Sphenoid sinus mucocele (SSM) is a rare condition in children, accounting for only 1% to 3% of paranasal sinus mucoceles, and can result in unexpected symptoms like blindness.
  • - A case study focused on a 9-year-old girl who experienced sudden vision loss due to SSM, leading to her diagnosis through an orbital MRI after first consulting an eye doctor.
  • - The girl underwent successful endoscopic surgery, which relieved her vision immediately, showcasing the importance of early diagnosis and intervention by various specialists to manage SSM effectively in pediatric patients.
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Background And Objective: The paranasal sinuses are cavities filled with air located within specific bones, namely the frontal, ethmoidal, maxillary, and sphenoidal sinuses. The ethmoidal sinus is composed of three groups: anterior, middle, and posterior, which are found on both sides. Haller cells (HC), also known as infraorbital ethmoid cells, are projections of the anterior ethmoid sinus that extend into the floor of the orbit and the upper part of the maxillary sinus.

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Mucoceles are locally invasive but benign expansive cystic lesions that can arise within paranasal sinuses. Isolated sphenoid sinus Mucoceles (SSM) are quite rare, comprising less than 1% of all paranasal sinus mucoceles. Due to the critical position and proximity of the sphenoid sinus to vital structures, SSMs can cause a multitude of symptoms and complications.

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