Sphenoid sinus mucocele masquerading as retrobulbar optic neuritis: a case report

Abri Aghdam Kaveh,Soltan Sanjari Mostafa,Zand Amin,Ghazi-Zadeh Ahsaei Mahya

doi:10.22336/rjo.2018.49

Abstract

Objective: To describe an infrequent instance of sphenoid sinus mucocele presenting as retrobulbar optic neuritis and highlight the value of imaging in the diagnosis and treatment plans. Methods: A woman aged 26 noted a sub-acute decrease in vision in the right eye, which mimicked optic neuritis. Magnetic resonance imaging (MRI) indicated a large mass in the sphenoid sinus, which was in favor of mucocele. Results: Endoscopic sphenoidotomy and marsupialization of the mucocele were carried out, and the diagnosis was confirmed by pathology. The patient was also administered a high dose of corticosteroid, upon which progression of the disease was halted. Unfortunately, no significant improvement in vision was achieved. Conclusions: This report emphasized the important role of imaging in differentiating between different causes of optic neuropathies. A high level of clinical skepticism along with appropriate imaging studies can help diagnose rare causes. With timely management, gratifying results may be achieved.

Highlights

Sphenoid sinus mucoceles occur infrequently and have a prevalence of one percent of all paranasal sinus mucoceles [1]
We describe an unusual incident of sphenoid sinus mucocele masquerading retrobulbar optic neuritis
Computed Tomography (CT) scan is necessary for evaluating the optic canal and the adjacent paranasal sinuses in patients with sinus diseases accompanied with visual disturbances

Summary

Introduction

Sphenoid sinus mucoceles occur infrequently and have a prevalence of one percent of all paranasal sinus mucoceles [1]. We describe an unusual incident of sphenoid sinus mucocele masquerading retrobulbar optic neuritis. One week after removing the mucocele, the right eyesight recuperated to counting fingers at 1 meter and the visual field was slightly improved (Fig. 3).

Results

Conclusion