OBJECTIVE: Aimed to analyse the clinical features of the patients with sphenoid sinus mucocele, achieve earlier diagnosis and more timely intervention and decrease the occurrence of misdiagnoses. METHOD: A retrospective study was first conducted in patients with sphenoid sinus mucoele treated in Xiangya hospital from Jan 2000 to Jan 2015. Then literature reports on this disease were collected and analyzed from China National Knowledge Infrastructure (CNKI) and Wan Fang database. RESULT: We collected 82 patients with sphenoid sinus mucocele treated in Xiangya hospital. There were 52 patients presented with headache, 31 patients presented with visual impairment, 10 patients presented with cranial nerve palsy, 2 patients presented with exophthalmos, 15 patients presented with nasal symptoms, and 5 patients with no obvious symptoms. There was no significant difference for symptoms distribution between male and female patients (P > 0.05). Among 45 patients with headache as first symptom and 10 patients with ethmoid sinus mucocele, there were 18 patients and 8 patients subsequently suffering from visual impairment, respectively. We also collected 161 patients in literature except for enrolling, the 82 patients treated in Xiangya hospital, and found that headache was the most common symptom, followed by visual impairment, in the two independent cohorts. CONCLUSION To the best of our knowledge, this is the study of maximum sample for sphenoid sinus mucocele in China. Headache and visual impairment are the most common symptoms for sphenoid sinus mucocele. Surgical treatment should be early performed when the desease accompanied with headache or ethmoid sinus mucocele, to avoid other complications such as visual impairment and even blindness.
China ; Cranial Nerve Diseases ; etiology ; Databases, Factual ; Diagnostic Errors ; Ethmoid Sinus ; Exophthalmos ; etiology ; Female ; Headache ; etiology ; Humans ; Male ; Mucocele ; complications ; diagnosis ; pathology ; Paranasal Sinus Diseases ; Retrospective Studies ; Sphenoid Sinus ; pathology ; Vision Disorders ; etiology

Endoscopic sinus surgery is effective to nasal sinus mucocele with eye symptoms as main manifestation. It is very importment to raise the awareness of the disease and to prompt imaging examination. Three cases were reviewed. One mucocele was found in the frontal sinus ethmoid sinus,1 in the fronto-ethmoid sinus and 1 in the spheno-ethmoid sinus. All cases were preoperatively diagnosed by CT, MRI or intranasal endoscopy. Nasal sinus mucocele with eye symptoms as main manifestation should be early diagnosed. Endoscopic sinus surgery is a safe and effective method for the treatment of nasal sinus mucocele,and could be the primary choice for it. All cases were treated by nasal endoscopic sinus surgery. The majority of symptoms, such as exophthalmos, epiphora and diplopia, disappeared in all patients. However, vision recovery was observed only in some patients.
Diplopia ; complications ; Endoscopy ; Ethmoid Sinus ; pathology ; Exophthalmos ; complications ; Frontal Sinus ; pathology ; Humans ; Lacrimal Apparatus Diseases ; complications ; Magnetic Resonance Imaging ; Mucocele ; complications ; diagnosis ; Paranasal Sinus Diseases ; complications ; diagnosis

No abstract available.
Aged ; *Ethmoid Sinus ; Humans ; Male ; Mucocele/*complications/radiography ; Ocular Motility Disorders/diagnosis/*etiology ; Paranasal Sinus Diseases/*complications/radiography ; Tomography, X-Ray Computed

OBJECTIVE: To draw the attention to mucosal antral cyst, thus reduce the probability of missed diagnosis and missed treatment by retrospectively analyzing 17 cases of eye pain patients with no obvious nasal symptoms in our department from January 2003 to September 2011. METHOD: All patients were performed ophthalmologic examination including eye position, eyesight, refraction, visual field, intraocular pressure and fundus examination, and the results showed that all of them had no eye disease. After excluding the deviation of nasal septum, concha bullosa and Haller gas room, CT scanning of paranasal sinus showed the maxillary sinus cyst. The patients were operated by nasal endoscope through joint path of middle meatus or inferior meatus and given antibiotics after operation. The nasal cavity packing was removed 24 hours postoperatively and the patients were discharged from hospital a week later. All the patients continued using intranasal corticosteroids and were followed up for half a year to observe whether the eye pain disappeared or recurred, when various processing was given to the surgical cavity with the help of nasal endoscope. RESULT: Among the 17 cases, 14 cases of eye pain disappeared after the operation, and the remaining 3 patients got symptomatic relief without recurrence during the follow-up period. CONCLUSION Mucosal antral cyst can cause eye pain. After excluding eye disease, once we diagnosed patients for mucosal antral cyst and the routine application of corticosteroids treatment was proved to be invalid, we should take operation treatment as early as possible, regardless of the size and location of the cysts.
Adolescent ; Adult ; Cysts ; complications ; diagnosis ; Eye Pain ; diagnosis ; etiology ; Female ; Humans ; Male ; Maxillary Sinus ; Middle Aged ; Mucous Membrane ; Paranasal Sinus Diseases ; complications ; diagnosis ; Retrospective Studies ; Young Adult

OBJECTIVE: To investigate the diagnostic and therapeutic methods of orbital apex syndrome caused by sinus diseases and to achieve earlier diagnosis and timely treatment. METHOD: Clinical data of 6 cases in our department from January 2008 to March 2012 were retrospectively analyzed. RESULT: All cases had surgical treatment. All cases were preoperatively diagnosed by CT, MRI or intranasal endoscopy. The postoperative pathology showed 2 cases with fungal sphenoiditis, 2 cases with ethmoid mucocele and 2 cases with sphenoid mucocele. CONCLUSION Orbital apex syndrome caused by sinus diseases is very rare. The possible causes of misdiagnosis are low incidence of the disease, nonspecific eye symptoms, and unawareness of the doctor, especially ophthalmologist. CT, MRI or intranasal endoscopy can greatly improve the diagnosis of the disease. Endoscopic sinus surgery is a safe and effective method for orbital apex syndrome caused by sinus diseases,which is the primary therapy for the disease.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Orbital Diseases ; diagnosis ; etiology ; therapy ; Paranasal Sinus Diseases ; complications ; diagnosis ; therapy ; Retrospective Studies ; Syndrome

In this case report we describe a 27-year-old man who presented with progressive enophthalmos for 5 months without any other associated ocular symptoms such as pain, diplopia, or visual disturbance. Computed tomography showed that his progressive enophthalmos originated from a frontoethmoidal mucocele and this caused destruction of the lamina papyracea and shrinkage of the ethmoidal air cell. Finally the enlarged orbital space caused an inward deviation of the eyeball. Endoscopic marsupialization was successfully performed by an otolaryngologist and did not result in any ophthalmologic sequelae. Although frontoethmoidal sinus mucoceles mostly frequently originates from orbital mucoceles, enophthalmic manifestations are very rare. Enophthalmic conditions are not as responsive to surgical interventions as exophthalmic conditions.
Adult ; Diagnosis, Differential ; Endoscopy ; Enophthalmos/diagnosis/*etiology/surgery ; *Ethmoid Sinus ; Follow-Up Studies ; *Frontal Sinus ; Humans ; Male ; Paranasal Sinus Diseases/*complications/diagnosis/surgery ; Time Factors ; Tomography, X-Ray Computed

OBJECTIVE: To review the clinical manifestations and management of nasal sinus mucoceles with visual loss. METHOD: Medical records for 23 patients of paranasal sinus mucoceles with visual impairment were re viewed retrospectively during 8-year period (from 2002 to 2010). Ten mucoceles were found in the frontal or fronto-ethmoidal sinuses, 6 in the ethmoidal sinuses, 7 in the sphenoidal or spheno-ethmoidal sinuses. Because the majority of early chief complaints were problems related to vision, patients were often seen by ophthalmologists first. Poor vision was more common in patients with sphenoid or spheno-ethmoidal sinus mucoceles because of their proximity to the optic nerve. CT and MRI were important tools for diagnosing nasal sinus mucocele. The patients received endoscopic surgery to remove mucocele and to decompress the optic nerve. Steroid therapy was given postoperatively and routine examination with endoscopy were carried out during follow-up. RESULT: Postoperatively, the majority of symptoms, such as exophthalmos, epiphora, diplopia and headache, disappeared in all patients. However, vision recovery was observed only in some patients. Recovery of vision depended on the timing of surgery and severity of initial visual loss. Delay in treatment can seriously compromise recovery of vision impairment. Moreover, patients without light perception before surgery had poor visual recovery even if optic nerve decompressions were performed. CONCLUSION Endoscopic surgery is effective to nasal sinus mucocele with visual loss. Because visual recovery depends on prompt diagnosis and surgical intervention, a good understanding of the disease and prompt imaging studies are important.
Adolescent ; Adult ; Cysts ; complications ; diagnosis ; surgery ; Female ; Humans ; Male ; Middle Aged ; Paranasal Sinus Diseases ; complications ; diagnosis ; surgery ; Retrospective Studies ; Vision, Low ; etiology ; Young Adult

Aged ; Brain Diseases ; etiology ; physiopathology ; Frontal Lobe ; pathology ; surgery ; Frontal Sinus ; Humans ; Male ; Mucocele ; complications ; diagnosis ; surgery ; Paranasal Sinus Diseases ; complications ; diagnosis ; surgery ; Syndrome

Cholesterol granuloma (CG) is usually associated with chronic middle ear disease, and is not common in the paranasal sinuses. Additionally, it is very rare for cases of CG to be associated with a fungal infection. However, in this paper, we report a case of sphenoid sinus CG that is associated with aspergilloma in a 78-year-old male patient who presented with right hemifacial pain, headache and toothache. CT revealed the presence of an expansile cystic mass lesion in the sphenoid sinus that showed a high signal intensity on both the T1 and T2 weighted images. This mass was later determined to be CG. The suspected etiologic mechanisms of both CG and aspergilloma of the paranasal sinuses are similar, and impaired drainage and obstruction of the ventilation of the paranasal sinuses are considered to be the causative mechanism of both diseases. Overall, the results of this study indicate that the use of MRI findings could be helpful for differentiating CG from other paranasal sinus mass lesions.
Aged ; Aspergillosis/*complications ; Granuloma/diagnosis/*etiology ; Humans ; Magnetic Resonance Imaging ; Male ; Paranasal Sinus Diseases/complications/*etiology ; *Sphenoid Sinus ; Tomography, X-Ray Computed

PURPOSE: To report a case of bilateral ophthalmic artery occlusion in rhino-orbito-cerebral mucormycosis. METHODS: Reviewed clinical charts, photographs, and fluorescein angiography RESULTS: An 89-year-old man with poorly controlled diabetes developed sudden bilateral ptosis, complete ophthalmoplegia of the right eye, and superior rectus palsy of the left eye. Brain and orbit magnetic resonance imaging showed midbrain infarction and mild diffuse sinusitis. On the 2nd day of hospitalization, sudden visual loss and light reflex loss developed. There were retinal whitening, absence of retinal arterial filling, and a total lack of choroidal perfusion on fluorescein angiography of the right eye. The left eye showed a cherry red spot in the retina and the absence of retinal arterial filling and partial choroidal perfusion on fluorescein angiography. On rhinologic examination, mucormyosis was noticed. Despite treatment, visual acuity and light reflex did not recover and he died 4 days after admission. CONCLUSIONS: Bilateral ophthalmic artery occlusion can occur in rhino-orbital-cerebral mucormycosis.
Aged, 80 and over ; Arterial Occlusive Diseases/diagnosis/*etiology ; Brain Diseases/*complications/diagnosis/microbiology ; Fatal Outcome ; Functional Laterality ; Humans ; Magnetic Resonance Imaging ; Male ; Mucormycosis/*complications/diagnosis/microbiology ; Ophthalmic Artery/*pathology ; Orbital Diseases/*complications/diagnosis/microbiology ; Paranasal Sinus Diseases/*complications/diagnosis/microbiology