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Unusual presentation of an asymptomatic pseudomeningocele within the sphenoid sinus

  • K J McNamara (a1), R P Exley (a1), S Khwaja (a2) and R K Bhalla (a3)

Abstract

Objective:

We report the rare case of a 55-year-old woman with an asymptomatic left sphenoid sinus pseudomeningocele mimicking a mucocele.

Case report:

A 55-year-old woman was found to have an incidental mass in the left sphenoid sinus on computed tomography. Magnetic resonance imaging confirmed the presence of a mucocele. A left endoscopic sphenoidotomy was performed to drain the mucocele. Despite an anatomical puncture through a stenosed sphenoid ostium, alarmingly, the opening leaked cerebrospinal fluid. A dehiscent lateral wall was identified with a dural opening communicating with the sphenoid sinus. This was immediately repaired with a free nasal septal mucosal graft. Six months post-operatively, the patient remained free from cerebrospinal fluid leakage.

Conclusion:

Pseudomeningoceles are extremely rare in the absence of trauma or iatrogenic injury. Surgeons should be alert to their presence as they can mimic a unilateral mucocele or nasal polyp. Endoscopic management lends itself to a single-stage repair.

Copyright

Corresponding author

Address for correspondence: Mr R K Bhalla, Department of Otolaryngology – Head and Neck Surgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK Fax: +44 (0)161 276 5003 E-mail: rajiv.bhalla@cmft.nhs.uk

References

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