Cases reported "Paranasal Sinus Diseases"

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1/16. Neurosurgical aspects of sphenoid sinus mucocele.

    The aetiological spectrum of sphenoid sinus mucocele includes congenital anomaly, trauma, infection, allergy and surgery of the sphenoid sinus. Enlargement of the mucocele, even with a short history, can result in progressive expansion of the sinus and extension of the lesion into the pituitary fossa, the suprasellar region, nasopharynx, orbits, clivus or ethmoid air cells. It is a benign cystic lesion with an excellent prognosis when treated appropriately. Generally, these lesions are managed by an ear, nose and throat surgeon, but when there is extension into the sellar and parasellar (especially suprasellar) regions they are managed by the neurological surgeon. sphenoid sinus mucocele should be considered in the differential diagnosis when there is suspicion of a cystic lesion in these regions. Three cases of large sphenoid sinus mucocele are presented, with discussion on their neurosurgical management and a review of the literature.
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ranking = 1
keywords = sella
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2/16. Value of Ga-67 SPECT in monitoring the effects of therapy in invasive aspergillosis of the sphenoid sinus.

    PURPOSE: We report a case of invasive sphenoid sinus aspergillosis clinically presenting as a pituitary mass. methods: After exploration via the trans-sphenoidal approach and subsequent treatment with amphotericin-B, Ga-67 brain SPECT was performed twice to monitor the therapeutic effect. RESULTS: Three months after antifungal treatment, Ga-67 brain SPECT showed partial resolution of the lesion in the sella turcica region. The patient continued with fluconazole treatment for another 2 months and received another Ga-67 brain SPECT, which showed complete clearing of the previous lesion. CONCLUSION: Ga-67 brain SPECT may play a potentially useful role in monitoring the therapeutic effect of treatment of invasive sphenoid sinus aspergillosis.
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ranking = 8.2510135118481
keywords = sella turcica, turcica, sella
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3/16. Sphenoidal sinus mucocele after transsphenoidal surgery for acromegaly.

    This report concerns one case of a sphenoid sinus mucocele occurring 17 years after transsphenoidal surgery for acromegaly. In 1979, a 51-year-old man was successfully operated by the transnasal transsphenoidal approach for a growth hormone (GH) adenoma 1 cm in diameter. In 1996, the patient was hospitalized for headaches and diplopia. He presented a loss of right visual acuity with paralysis of the right oculomotor nerve. The basal GH level was normal with a satisfactory decrease after oral glucose ingestion. Pituitary sellar radiography showed a disappearance of the posterior clinoid while magnetic resonance imaging revealed the existence of a bilocular, circular, homogeneous lesion of the sphenoid sinus 3 cm in diameter with a posterior and lateral extension. The diagnosis of mucocele was confirmed by surgical treatment, allowing drainage of the mucocele through a transsphenoidal approach. The drained material was composed of sinus epithelium containing many polynuclear and resorptive cells. Postoperatively, the symptoms decreased dramatically, leading to full recovery of visual function and disappearance of the headaches. Apart from the tumor recurrence, the mucocele of the sphenoid sinus can be evoked as a possible long term complication of transsphenoidal surgery for pituitary adenoma.
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ranking = 0.25
keywords = sella
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4/16. Monostotic fibrous dysplasia of the sphenoid sinus: a serendipitous finding on a bone scan.

    A 22-year-old woman had a Tc-99m MDP whole-body scan for low back pain. A focal area of increased activity was seen in the skull base in the region of the sella turcica. A computed tomographic examination showed ground-glass opacification of the sphenoid sinus and bony sclerosis along its walls, characteristic of fibrous dysplasia. Monostotic fibrous dysplasia, the more common form compared with the polyostotic variety, occurs in 70% to 80% of all patients with fibrous dysplasia. Monostotic lesions usually involve the ribs, femur, tibia, cranium, maxilla, and mandible. The frontal and sphenoid bones are the cranial bones most commonly involved.
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ranking = 2.2128325281141
keywords = turcica, sella
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5/16. Endonasal endoscopic treatment of parasellar arachnoid cyst: report of a case.

    A 40-year-old man presented with intractable headache of 5-year duration and a 1-month history of intermittent cerebrospinal fluid (CSF) rhinorrhea. magnetic resonance imaging showed a cystic lesion with signal characteristics similar to that of CSF. The patient underwent endonasal endoscopic surgery of the sphenoid sinus and the fistula was reinforced with facia, muscle cartilage, and posterior septal flap while performing cystocisternostomy. The postoperative course was uneventfiul CSF leakage stopped, and headache improved. Postoperative imaging revealed total collapse of the cyst cavity. Based on our findings, endonasal endoscopic treatment of the sellar and parasellar arachnoid cysts, if presenting into the sphenoid sinus, could be an acceptable minimally invasive alternative to the conventional modalities.
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ranking = 1.5
keywords = sella
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6/16. A rare expression of neural crest disorders: an intrasphenoidal development of the anterior pituitary gland.

    congenital abnormalities of the pituitary gland are rare and may be associated with midline cranial, orbital, and facial anomalies and with hormonal insufficiency. Here we report a case of asymptomatic, abnormal migration of the adenohypophysis. The normally developed adenohypophysis was located in the sphenoid bone and developed on the intersphenoidal septum, extending from the superior pharyngeal wall to the floor of the sella turcica (craniopharyngeal canal). The abnormal migration of the pituitary gland was isolated without hormonal deficit, brain, or facial developmental anomalies.
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ranking = 8.2510135118481
keywords = sella turcica, turcica, sella
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7/16. sphenoid sinus brown tumor, a mass lesion of occipital bone and hypercalcemia: an unusual presentation of primary hyperparathyroidism.

    Brown tumor is a focal lesion of the bone caused by primary or, less commonly, secondary or tertiary hyperparathyroidism (HPT). While the mandible is the most frequently involved bone in the head and neck region, atypical involvement of the cranium in the area of the sphenoid sinus is exceedingly rare. In the literature, a unique case of brown tumor of the sphenoid sinus was reported in a patient with primary HPT. We present a case of sphenoid sinus and occipital bone brown tumor associated with primary HPT. A 47-yr-old woman presented a 2-yr history of headaches, dizziness, diffuse body and articular pain, fatigue, and a 6-month history of intermittent nausea and vomiting, polydipsia, and polyuria. magnetic resonance imaging (MRI) demonstrated an expansive mass lesion in the sphenoid sinus with erosion of the sellar floor and medial wall of the right orbit, and expansion in the medulla of bone. Examination of biopsy specimens obtained from sphenoid sinus mass confirmed the diagnosis of brown tumor. The biochemical laboratory studies showed elevation of parathyroid hormone and confirmed the diagnosis of primary HPT. Excision of a parathyroid adenoma affected the metabolic status into normalizing. At the follow-up of 12 months postoperatively, the size of sphenoid sinus brown tumor decreased and the mass of occipital bone disappeared. In conclusion, this is a first report of primary HPT masquerading as a destructive fibrous sphenoid sinus brown tumor associated with a mass lesion of occipital bone and hypercalcemia in the literature.
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ranking = 0.25
keywords = sella
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8/16. Painful ophthalmoplegia secondary to a mucocele involving the sella turcica, superior orbital fissure, and sphenoid sinus.

    A case of painful ophthalmoplegia associated with an extensive lesion involving the sella turcica, superior orbital fissure, and sphenoid sinus in a 57-year-old man is reported. Even though nasal and ocular symptoms and signs represent the usual features of sphenoidal mucoceles, extension to the intracranial cavity as seen in this lesion is rare. Surgical exploration via a sublabial, transseptal approach revealed a mucocele of the sphenoid sinus. This case exhibited extensive and aggressive behavior simulating a malignant neoplasm.
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ranking = 41.255067559241
keywords = sella turcica, turcica, sella
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9/16. Epidermoid cyst of the sphenoid sinus with extension into the sella turcica presenting as pituitary apoplexy: case report.

    BACKGROUND: Epidermoids of the central nervous system are rare tumors. They are usually found in the fourth decade of life and most commonly off midline in the cerebellopontine angle. We report here a rare case of an epidermoid arising from the sphenoid sinus with extension into the sella and adjacent structures with acute onset of neurological deficit. The significance of the clinical presentation resembling pituitary apoplexy and magnetic resonance imaging (MRI) findings is noted. CASE DESCRIPTION: A 25-year-old man presented with acute severe headache, diplopia, and decreased visual acuity. Examination revealed right-sided ptosis and paresis of the third cranial nerve on the right side. Computed tomography and MRI were suggestive of a slow-growing sphenoid sinus mass with extension into the sella. The sublabial transsphenoidal approach was used to remove the mass under direct visualization. The patient's neurological status improved to baseline both subjectively and objectively after the operation. CONCLUSION: Epidermoids, although rare, should be considered as part of the differential diagnosis when evaluating lesions of sphenoid sinus or sellar origin.
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ranking = 33.754054047392
keywords = sella turcica, turcica, sella
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10/16. aspergillosis of the sphenoid sinus simulating a pituitary tumor.

    Sphenoidal aspergillosis is an unusual cause of sella turcica enlargement. Pituitary abscess secondary to aspergillus had been reported. In the present case, a woman with sphenoid sinus aspergillosis mimicked a pituitary tumor. This patient survived her infection with intact pituitary function following a transsphenoidal approach. No postoperative amphotericine-B and 5-fluorocytosine were necessary. CT scan revealed a mass occupying the sphenoid sinus extending to the sella turcica. Factors that should alert the clinican to the presence of a sphenoidal and pituitary abscess in a patient with sella turcica enlargement are prior episodes of sinusitis, meningitis and immunosuppression and, as in the present case, hyperglycemia.
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ranking = 24.753040535544
keywords = sella turcica, turcica, sella
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