Neurosurgical aspects of sphenoid sinus mucocele

The aetiological spectrum of sphenoid sinus mucocele includes congenital an omaly, trauma, infection, allergy and surgery of the sphenoid sinus. Enlarg ement of the mucocele, even with a short history, can result in progressive expansion of the sinus and extension of the lesion into the pituitary foss a, the suprasellar region, nasopharynx, orbits, clivus or ethmoid air cells . It is a benign cystic lesion with an excellent prognosis when treated app ropriately. Generally, these lesions are managed by an ear, nose and throat surgeon, but when there is extension into the sellar and parasellar (espec ially suprasellar) regions they are managed by the neurological surgeon. Sp henoid sinus mucocele should be considered in the differential diagnosis wh en there is suspicion of a cystic lesion in these regions. Three cases of l arge sphenoid sinus mucocele are presented, with discussion on their neuros urgical management and a review of the literature.