Vol.102 No.3 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 102 No. 3 March 2009
A Case of an Arachnoid Cyst Extending to the Sphenoid Sinus
Fumiko Kuboshima
(Kyoto Katsura Hospital)
Takayuki Nakagawa, Tatsunori Sakamoto and Juichi Ito
(Kyoto University Graduate School of Medicine)
Arachnoid cysts are commom intracranial lesions; however, their extension to the paranasal sinus is rare. Here we report a case of arachnoid cyst extending to the sphenoid sinus. Imaging examinations indicated an epidermoid cyst. We then performed endoscopic transsphenoidal surgery for partial resection of the cyst or formation of a drainage route. Opening the cyst wall resulted in a massive CSF leak, indicating an arachnoid cyst. Management of CSF leakage requires complete closure of the defect in the skull base using a fat graft and a pedicle mucosal flap elevated from the nasal septum. An arachnoid cyst should be included in the differential diagnosis of intracranial cystic lesions extending to the paranasal sinuses.
Key words :arachnoid cyst, sphenoid sinus, endoscopic transsphenoidal surgery, CSF leak