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Unusual presentation of an asymptomatic pseudomeningocele within the sphenoid sinus

Published online by Cambridge University Press:  15 October 2013

K J McNamara ,
R P Exley ,
S Khwaja  and
R K Bhalla
K J McNamara
Affiliation:
Department of Otolaryngology, Tameside Hospital, Ashton-Under-Lyne, UK
R P Exley
Affiliation:
Department of Otolaryngology, Tameside Hospital, Ashton-Under-Lyne, UK
S Khwaja
Affiliation:
Department of Rhinology, Central Manchester Foundation Trust, UK
R K Bhalla*
Affiliation:
Department of ENT, University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Foundation Trust, UK
*
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
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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.

Keywords

Sphenoid SinusMucoceleSkull BaseMeningocele
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 12 , December 2013 , pp. 1238 - 1241
Copyright
Copyright © JLO (1984) Limited 2013 

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