CASE REPORT   

Otorhinolaryngology 2023 March;73(1):18-21

DOI: 10.23736/S2724-6302.21.02399-9

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Spontaneous sphenoid mucocele in a 6-year-old child

Antonio GIUNTA ¹, Francesca CANDELORI ¹, Giulia ZAMBONINI ², Salvatore CATALANO ², Claudia CASSANDRO ³ ✉, Andrea ALBERA ³, Alfonso SCARPA ⁴, Pasquale VIOLA ⁵, Antonio CORTESE ⁶, Filippo RICCIARDIELLO ⁷, Ettore CASSANDRO ⁴

¹ ENT Department, Santa Maria Hospital, Terni, Italy; ² ENT Department, Santa Maria della Misericordia Hospital, Perugia, Italy; ³ Department of Surgical Sciences, University of Turin, Turin, Italy; ⁴ Department of Medicine and Surgery, University of Salerno, Salerno, Italy; ⁵ Unit of Audiology, Department of Experimental and Clinical Medicine, Regional Centre for Cochlear Implants and ENT Diseases, Magna Graecia University, Catanzaro, Italy; ⁶ Unit of Maxillofacial Surgery, Department of Medicine and Surgery, University of Salerno, Salerno, Italy; ⁷ ENT Department, AORN A. Cardarelli, Naples, Italy

Mucoceles of the paranasal sinuses are rare diseases with slow evolution. They are benign, encapsulated, and destructive cysts filled with mucous and covered by respiratory epithelium. Among the paranasal sinuses, the sphenoid is affected the least. In children isolated sphenoid mucocele is rarer than adults, usually does not develop in early childhood and typically is not seen until the patient is at least 3 years old. We presented a case of mucocele of the sphenoid sinus in a 6-year-old child. We consider clinical presentation, use of neuroimaging for diagnosis, surgical treatment, and postoperative results. The patient presented with persistent headache and paresis of the oculomotor nerves. Because the symptoms of pediatric sphenoid sinus mucoceles tend to be variable and nonspecific, CT remains the standard for evaluating the disease. In addition, MRI is an essential adjunct in the diagnosis and selection of treatment for suspected tumors of the sphenoid sinus. Sphenoidal mucoceles should be considered as a diagnosis in cases of persistent headache with retrobulbar or vertex location and ocular symptoms. Endoscopic trans nasal marsupialization of the mucocele and antibiotic therapy were performed, leading to complete remission and there was no evidence of recurrence after 12 months follow-up. This suggests that endoscopic trans ostial approach was especially suitable for the management of pediatric benign isolated sphenoid sinus lesions.

KEY WORDS: Mucocele; Sphenoid sinus; Child; Diplopia; Headache; Neuroimaging