DR. SREELAKSHMI ARUN

DR. ANN RESHMA RAJAN, DR. ANTHRAYOS C.V. KAKKANATT

Abstract

63 year old male with no known co-morbidities presented with a 1 month history of occasional deep seated headache & 2 weeks history of diplopia on left lateral gaze. On examination vision was 6/12 in both eyes, movement restriction on left lateral gaze and fundus examination showed bilateral papilledema. OCT-ONH showed bilateral disc edema. MRI taken reported –features suggesting the possibility of mucocele involving left sphenoid sinus producing mass effect on cavernous sinus, dorsum sella, body of sphenoid & part of clivus. Lesion closely abutting optic nerve at orbital apex. Patient was referred to ENT and Neuro-Surgery departments for further management . Endoscopic decompression of the left sphenoid sinus was done. Sphenoid sinus mucoceles are extremely rare (incidence-1%). They can compress optic canal, superior orbital fissure and can cause ptosis ,ophthalmoplegia, diplopia due to 3rd or 6th cranial nerve palsies & optic neuropathy.