Bilateral compressive optic neuropathy secondary to bilateral sphenoethmoidal mucoceles

Rhinogenic Optic Neuritis Caused by Sphenoid Mucocele with Sinusitis

A 59-year-old male who presented with a nonspecific headache at the vertex, resembling retrobulbar optic neuritis, was treated as such but did not show any improvement. Although optic nerve compression from sphenoid mucocele was finally discovered, the delayed diagnosis and improper treatment led to a permanent visual loss. Optic neuritis could be caused by a common problem, “mucocele/sinusitis,” but might be easily overlooked in general practice. Rhinogenic optic neuropathy should, therefore, be considered in every case of optic neuritis whenever atypical presentation occurs or is unresponsive to high-dose steroid treatment.

[Bilateral sphenoid sinus mucocele presenting as abducens nerve palsy: case report]

Mucocele is a rare, benign, cystic tumor affecting primarily adults. It arises within the sphenoid sinus and invades the orbit through bony destruction. The most frequent locations are frontal and fronto-ethmoidal; sphenoidal forms are rarer, and bilaterality is exceptionally rare. Ophthalmological signs with the risk of blindness required emergency treatment. The authors report a case of bilateral sphenoid mucocele presenting as an isolated abducens nerve palsy, the etiological investigation confirmed the diagnosis of sphenoid mucocele, and the treatment consisted of a surgical marsupialization through an endonasal endoscopic approach.

[Compressive optic neuropathy related to an anterior clinoid mucocele]

Nasal sinus mucoceles are an uncommon cause of painful optic neuropathy. We report the case of a patient presenting an acute compressive optic neuropathy related to an anterior clinoid mucocele. The diagnosis was mainly made with CT and MRI, and the patient was treated with endoscopic endonasal transseptal surgery 10 days after the beginning of the disorder. Visual recovery was complete 3 days later. We review the literature on the etiologies of this type of pathology, the work-up, and the possible treatments.

Visual-Field Loss Caused by Sinusitis: A Case Report

The author reports a case of visual-field loss that was not characterized by any direct compression or external signs of sinus disease. The patient's hemianopia was found to be associated with severe sinusitis, which had not been clinically apparent and which had not extended beyond the bony walls of the sinuses. Following surgical drainage of the affected sinuses, the hemianopia resolved immediately and completely.

A mucopyocele of the clivus: case report

OBJECTIVE AND IMPORTANCE

There are increasing reports of nasal sinus mucopyoceles eroding the base of the cranium and causing the rapid onset of neurological complications. Uncommon presentations can mimic tumors, but the infectious nature mandates an urgent surgical decompression. It is important to document these uncommon presentations. CLINICIAL PRESENTATION: A mucopyocele of the clivus is reported in a patient with a frequent history of sinusitis. Diplopia caused by an acute sixth nerve palsy prompted the radiological diagnosis with computed tomography and magnetic resonance imaging.

INTERVENTION

Transsphenoidal drainage of the lesion lead to marked improvement in the patient.

CONCLUSION

This is the third reported case of a clival mucocele. Mucoceles of nasal sinuses can erode intracranially, causing neurological sequalae, and clival involvement is extremely rare. Early drainage leads to marked improvement.