Sphenoidal mucopyocele with visual impairment: case report of a rare disease and literature review

Abstract

Background: The sphenoid sinus is affected in 2 % of the cases presenting with a mucocele or mucopyocele of the paranasal sinuses. The close proximity of the optic nerve usually results in visual symptoms. Timely diagnosis and treatment is required to prevent permanent loss of vision. Case: A 28 years old male presented at our center with left sided periorbital pain with progressive blurring of vision for 3 years. A mucocele of the sphenoid sinus was identified on CT and MRI scans. Endoscopic sphenoidotomy revealed a mucopyocele of the sphenoid sinus with a dehiscent roof. Marsupialization of the sac was performed. Following surgery, there was improvement of periorbital pain, however, the vision remained static without further deteoration. Conclusion: Mucopyoceles of the sphenoid sinus require early recognition to prevent the debilitating visual symptoms. CT scan is the preferred imaging modality and endoscopic approach is the recommended approach for marsupializaion of the sac.