Vol. 98  No. August 2005

A Case of Huge Primary Sphenoidal Mucocele          

Eiken Matsuda and Shunji Tanimoto
(Yoka Public Hospital)

      We report a case of huge primary mucocele of the left sphenoid sinus. The patient was a 55-year-old male with a one-month history of left visual disturbance. The patient did not have a history of paranasal sinus surgery nor injury. CT and MRI findings demonstrated that the expansive cystic lesion measured about 5 cm, and primarily occupied the parapharyngeal space. The interior the lesion appeared uniform and there was no imaging effect. Since the occupation part of this lesion differed from the general part of paranasal sinus mucocele, discrimination between tumor and mucocele was needed. Endoscopic sinus surgery was performed under local anesthesia. Mucus secretions within the mucocele were removed, and a wide opening was made in the nasal cavity. Left visual disturbance gradually improved postoperatively.
     There have been 88 cases of paranasal sinus mucocele treated at Yoka Public Hospital in the past 11 years. The majority consisted of postoperative maxillary mucocele, whereas primary mucocele comprised only 4 cases. In postoperative paranasal mucocele, the period from the last surgery to symptom appearance was 26.9 years on average. As treatment, surgery was performed on about 70 percent of the paranasal sinus mucocele cases, and about 10 percent were left intact. The period from symptom appearance until surgery was 10.7 months on average, and that was for one week to a maximum of ten years. Many patients had long periods of illness, therefore, it is better to perform surgery when patients have symptoms.

Key words : primary sphenoidal mucocele, visual disturbance, endoscopic sinus surgery


第98巻8号 目次   Vol.98No.8contents