OBJECTIVETo investigate the presenting symptoms and signs, endoscopic findings, imaging changes and the clinical outcomes of endoscopic surgery in 23 patients with sphenoid mycetoma.

METHODSThe clinical data and the follow-up results of endoscopic surgery in 23 patients with sphenoid mycetoma, between April 2001 and January 2006, were retrospectively analysed.

RESULTSThe study population included 15 women and 8 men with a median age of 52.7 years. Presenting symptoms included headache (13 cases, 57%) and bloody discharge (9 cases, 48%). The computed tomography scans showed high density shadow in all 23 cases, with 17 cases (74%) had plaque or cord shaped calcification. All patients were treated by endoscopic transnasal approach. No surgical complications were found. Follow-up ranged 3-18 months, all symptoms disappeared, except strabismus in one case after 7 months of operation. The mucosa in surgical cavity is good.

CONCLUSIONSThe most common clinical symptoms of sphenoid mycetoma are headache and bloody discharge. Computed tomography scan has great value for the diagnosis of sphenoid mycetoma. The minimal invasion and the good outcome are the main advantages of the endoscopic surgery.