Mucocele of the Sphenoid Sinus as a Rare Cause of Isolated Oculomotor Nerve Palsy: Case Report and Review of the Literature

Wenting Li, Jiancong Huang, Luoying Yang, Lihong Chang and Gehua Zhang

Department of Otolaryngology, Head & Neck Surgery, Sun Yat-sen University, China

^*Correspondance to: Lihong Chang 

 PDF  Full Text DOI: 10.25107/2474-1647.1207

Abstract

Mucocele of sphenoid sinus is a rare cause of oculomotor nerve palsy. A 59-year-old male presented with a 2-week history of sudden ptosis of his right eyelid and right internal ophthalmoplegia. Laboratory examination and radiological evaluation revealed mucocele of the right sphenoid sinus with diabetes and chronic rhinosinusitis. The patients underwent nasal endoscopic surgery and the right sphenoid sinus mucocele was confirmed. The patient recovered completely after 2weeks. One year follow up indicated no recurrence. A sphenoid sinus mucocele presents various clinical symptoms due to its relationship to the adjacent cavernous sinus and the base of skull. Involvement of isolated oculomotor nerve palsy in sphenoid sinus mucocele is rare. The differential diagnosis between compressive lesion caused by mucocele of sphenoid sinus and ischemic lesion caused by diabetes should be noticed. Careful clinical evaluation and appropriate radiologic imaging can help to identify a definitive cause. Computed tomography and magnetic resonance imaging are useful in explaining the clinical symptoms of mucocele of sphenoid sinus by identifying the spreading of the lesion. Proper and timely endoscopic marsupialization of the mucocele lead to complete resolution of the oculomotor nerve palsy.

Keywords

Mucocele; Sphenoid sinus; Oculomotor nerve palsy; Ptosis

Cite the article

Li W, Huang J, Yang L, Chang L, Zhang G. Mucocele of the Sphenoid Sinus as a Rare Cause of Isolated Oculomotor Nerve Palsy: Case Report and Review of the Literature. Clin Surg. 2016; 1: 1207.