Sphenoid sinus mucocele

Last revised by Mostafa Elfeky on 22 Aug 2023

A sphenoid sinus mucocele is a location-specific subtype of a paranasal sinus mucocele

Sphenoid sinus mucoceles are uncommon and only account for around 1-2 % of all paranasal sinus mucoceles 1-7.

Can be variable and range from deep-seated headaches to cranial nerve palsies.

As with other mucoceles, they occur from accumulation and retention of mucoid secretions within the sinus and in turn can lead to thinning, distension and erosion of one or more of its bony walls.

They can occur in isolation or in combination with other paranasal sinus mucoceles.

Appears as opacification of the affected sphenoid sinus with bony expansion +/- erosion.

An expanding sphenoid sinus mucocele may compress adjacent structures such as

  • the optic nerve
  • the cavernous sinus which carries the III, IV and VI cranial nerves.

Surgical options include endoscopic transnasal sphenoidotomy with sufficient removal of the anterior and inferior walls of the sinus. This can facilitate adequate drainage. Marsupialization via a transnasal transsphenoidal approach is another option.

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