Endoscopic sinus surgery of huge sphenoid sinus mucocele - Case report

Mucocele is the most common expansile benign lesion of the paranasal sinuses. Only about 1% of these mucoceles arise within the sphenoid sinus. In July of 1995, we encountered a case who suffered from nasal obstruction, snoring, and headache since 6 months before. Past history showed that he rcceived Caldwell-Luc's operation 30 years before. CT scan revealed a huge mucocele in the left sphenoid sinus. Marsupialization of the mucocele via transnasal endoscopic approach was performed after ophthalmo logical and neurosurgical consultations. Only minimal blood loss occurred during operation and the patient was discharged 2 days later without any intracranial or ophthalmological sequelae. Functional endoscopic sinus surgery carries the potential of treating mucoceles intranasally under local or general anesthesia with a dramatic reduction of morbidity. The entire operation can bc performed under direct visualization, trauma to normal sa and structures is minimized.