MUCOCELE OF THE SPHENOID SINUS - A LATE COMPLICATION OF TRANS SPHENOIDAL PITUITARY SURGERY

In an Is-month period, 3 cases of sphenoidal mucocele following pituit ary surgery were diagnosed at our institution. Only 1 case of this lat e-onset disorder has yet been reported as a pitfall of the transspheno idal route. Symptoms include recurrent headache and visual complicatio ns. Diagnosis was delayed because of misinterpretation of the magnetic resonance imaging findings, which actually showed the development of a sphenoid mucocele long before clinical symptoms occurred. These 3 ca ses suggest that attention should be focused not only on the sella tur cica, but also on the sphenoid sinus, in analyzing the magnetic resona nce imaging data. The treatment consists of endoscopic transnasal mars upialization, since the mucocele is lined by normal epithelium with an inflammatory reaction that will heal with drainage. At the time of su rgery, prevention would require either endoscopic control of the mucos al remnants, in case of sinus exclusion, or leaving the sphenoid sinus air-filled under a sealed sella.