蝶形骨洞に進展したクモ膜嚢胞例

Abstract

Arachnoid cysts are commom intracranial lesions; however, their extension to the paranasal sinus is rare. Here we report a case of arachnoid cyst extending to the sphenoid sinus. Imaging examinations indicated an epidermoid cyst. We then performed endoscopic transsphenoidal surgery for partial resection of the cyst or formation of a drainage route. Opening the cyst wall resulted in a massive CSF leak, indicating an arachnoid cyst. Management of CSF leakage requires complete closure of the defect in the skull base using a fat graft and a pedicle mucosal flap elevated from the nasal septum. An arachnoid cyst should be included in the differential diagnosis of intracranial cystic lesions extending to the paranasal sinuses.