[Clinical manifestation of muco- and pyocele of the sphenoid and ethmoid sinuses (author's transl)].

We, neurosurgeons, frequently encounter patients whose chief compiants are visual disturbance, disorder of the ocular movement, trigeminal neuralgia and/or panhypopituitarism wich have been called as superior orbital fissure syndrome or orbital apex syndrome. Among these, there might be considerably high incidence of mucocele or pyocele of posterior ethmoid sinuses. We have experienced 12 cases of mucocele in past 5 years, which were confirmed by operation. The most reliable method to diagnose mucocele or pyocele at this moment is by the radiogical procedures, and among all, tomogram of the skull is essential. This procedure not only clearly demonstrates the existence of mucocele in a certain sinus but also provides us informations about the surrounding bony stracture. Diagnosis becomes more definite if the epipharyngography demonstrates no filling of postive contrast medium into suspected paranasal sinuses. Treatment of choice for this disease is firstly drainage of mucocele or pyocele by transnasal approach, to avoid postoperative meningitis or brain abscess, and secondarily dissection of the arachnoidal adhesion around the optic chiasm by intracranial approach if it is necessary. Recently, we perform the drainage of mucocel and peeling off of affected mucosa via transnasal route using microsurgical technique. Results are all satisfactory.