Fungal mucopyocele of the sphenoid sinus revealed by oculomotor and abducens nerve palsy: a case report.

Mucoceles of the sphenoid sinus are very rare accounting for 1% of all paranasal sinus mucoceles. Clinical symptoms are non-specific, extremely variable, and only occur when the mucocele impinges on surrounding structures. Secondary infection of a mucocele content is called mucopyocele and often result in rapid enlargement and acute onset of symptoms. The sphenoid sinus is closely related to important and vital structures accounting for the broad spectrum of clinical presentations. In this report we describe the case of a fungal mucopyocele of the sphenoid sinus, revealed by oculomotor and abducens nerve palsy, managed via endoscopic sphenoidotomy with complete postoperative resolution of ocular symptoms. Few reports in the recent literature have described a similar condition with insights on clinical aspects, surgical implications and functional outcomes.