Mucocoele of the sphenoidal sinus eroding the petrous temporal bone.

Abstract

As mucocoeles of the air sinuses enlarge they produce pressure atrophy and expansion of the sinus walls, and tend to extend along the line of least resistance. The lesion is usually diagnosed initially as a neoplasm. Sphenoidal sinus mucocoeles are rare, about 60 cases having been reported. Only in a few of these was the correct diagnosis made on clinical and radiological findings. The common path of expansion is forwards into the orbit and posterior ethmoidal sinuses, and this produces ocular defects such as muscle paralysis, exophthalmos and visual disturbances from pressure on the optic nerve. The patient frequently complains of headache which is frontal or parietal and often unilateral. Other less common features include endocrine disturbance, 5th nerve pain and bulging of the posterior nasopharyngeal wall. Nasal symptoms and signs were present in only one third of the cases reported by Lundgren and Olin (1961). A 50-year-old labourer gave a history of headache in the left parietal region and left-sid...