1Final Year Post Graduate, Department of Radiodiagnosis, Sree Balaji Medical College and Hospitals (BIHER), India
2*Associate Professor of Radiology, Sree Balaji Medical College and Hospitals (BIHER), India
Corresponding Author
3Professor and HOD, Department of Radiodiagnosis, Sree Balaji Medical College and Hospitals (BIHER), India
Background: Isolated sphenoid sinus mucocele is a rare paranasal sinus pathology that may produce significant neurological and ophthalmological complications because of the close anatomical relationship between the sphenoid sinus and critical neurovascular structures. Visual impairment may occur when the expanding lesion compresses the optic nerve or optic canal, making early radiological diagnosis essential.
Case Presentation: A 43-year-old male presented with progressive diminution of vision in the left eye for approximately 40 days, accompanied by intermittent headache and nasal symptoms. Initial clinical evaluation suggested retrobulbar neuritis and corticosteroid therapy was started, but no improvement was observed. Subsequent radiological evaluation revealed a soft-tissue lesion occupying the sphenoid sinus with expansion of the sinus cavity and erosion of the sphenoid wall, resulting in narrowing of the left optic canal. Magnetic resonance imaging demonstrated a well-defined T2-hyperintense lesion extending toward the posterior ethmoid region corresponding to the Onodi cell, causing compression of the optic nerve. Based on these findings, a diagnosis of isolated sphenoid sinus mucocele producing compressive optic neuropathy was established. The patient underwent endoscopic transnasal trans-sphenoidal optic nerve decompression, with postoperative imaging demonstrating adequate sinus decompression.
Conclusion: This case highlights the diagnostic importance of high-resolution CT and MRI in evaluating sphenoid sinus lesions presenting with visual symptoms. Early recognition of radiological features such as sinus expansion, optic canal involvement, and anatomical variations like the Onodi cell is essential to avoid misdiagnosis and enable timely surgical management.
Keywords: Sphenoid sinus mucocele; Optic nerve compression; Onodi cell; CT; MRI; Visual loss; Radiology case report.
How to cite this article: Sundar B, Reddy SK, Murugan G. Isolated sphenoid sinus mucocele presenting as acute visual loss: A radiological diagnostic challenge. Int J Drug Deliv Technol. 2026;16(6s): 485-490; DOI: 10.25258/ijddt.16.6s.51
Source of support: Nil
Conflict of interest: None