Two Cases of Sphenoidal and Posterior Ethmoidal Mucoceles With Eye Symptoms

Abstract

Case 1: A 36 years old female, who had been operated on bilateral maxillar and ethmoidal sinuses 14 years before, complained of the deep pain and sudden blindness of the left eye. Tomograms of the skull revealed a marked cloudness of the left sphenoidal and ethmoidal sinuses. Three months after the visual loss, she was admitted to our clinic as left sphenoidal mucocele. A radical operation via the frontal sinus was performed, and an ethmoidal cyst and a sphenoidal cyst were found and removed. These cysts were completely seperated each other and had some different colored and natured contents. Cystgraphic examinations with injection of a contrast medium revealed clearly their characteristic location.
Case 2: A 39 years old male complained of oculomotor palsy with blepharoptosis of the right eye suddenly. He had not been suffered from any nasal desease, although he had been treated for bleeding in vitreous body of the right eye for 2 years. Plain skull films disclosed loss of the floor of the. sella turcica. Tomograms of the skull suggested that the erosion of the floor of the sella turcica was from below rather than from above. One month after the onset of ptosis, an extranasal operation through the frontal sinus was performed. Two cysts in the posterior ethmoidal and sphenoidal sinuses were found and removed as well as in the Case 1. Cystgraphic examination with a contrast medium during the operation revealed the anatomic relationship of two cysts. On the first postoperative day, the ptosis disappeared completely.
From the operative and radiological findings, it was suggested that the cyst in the posterior ethmoidal cells caused sphenoidal mucocele secondarily.