A sphenoid sinus mucocele is a location-specific subtype of a paranasal sinus mucocele.
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Epidemiology
Sphenoid sinus mucoceles are uncommon and only account for around 1-2 % of all paranasal sinus mucoceles 1-7.
Clinical presentation
Can be variable and range from deep-seated headaches to cranial nerve palsies.
Pathology
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.
Radiographic features
CT
Appears as opacification of the affected sphenoid sinus with bony expansion +/- erosion.
Complications
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.
Treatment and prognosis
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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