Sphenoid sinus mucocele.

Sphenoid sinus mucocele is a rare entity that can occur alone or as a result of ethmoid sinusitis and polyposis. A myriad of presentations is possible due to the presence of important contiguous neurologic and vascular structures. Past surgical approaches to the sphenoid sinus have problems associated with them. The endoscopic sinus technique offers outstanding visualization and a safe, straight-forward approach to the sphenoid sinus. Four patients with documented mucocele of the sphenoid sinus were treated successfully with endoscopic sinus surgery. The technique involves partial removal of the inferior middle turbinate and direct entrance into the sphenoid sinus through the anterior sinus wall. Other sinus abnormalities can be treated simultaneously as required. Sphenoid sinus mucocele is discussed from the standpoint of cause, clinical presentation, and treatment options.