Sudden Blindness as the Only Symptom Caused by a Small Sphenoid Sinus Mucocele in a Young Child.

Feng-Li Cheng, Lan Han, Dan-Ni Xu, Fei-Yang Li, Ting-Ting Li, Shi-Yong Liang, Yun-Fang An, Chang-Qing Zhao
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Abstract

Background: Sphenoid sinus mucocele (SSM) represents a relatively rare disease among pediatric population as compared to adults, with a 1% to 3% incidence of all paranasal sinus mucoceles. Since the initial symptoms varied often, SSM caused blindness was scarcely seen. Case Presentation: Here we described an unusual case of small, isolated SSM causing acute visual loss in a 9-year-old girl. The patient first consulted an ophthalmologist for her right blindness. A diagnosis of SSM was suspected indicated by an orbital MRI scan. Thereafter the patient was referred to our department and an endoscopic sphenoidotomy and optic nerve decompression was performed. Surprisingly, her vision was relieved immediately after surgery, followed by dramatic improvement during the postoperative 20-month follow-up period. Conclusion: To our knowledge, a better understanding of SSM in pediatrics is essential for clinicians, including neurologists, ophthalmologists, and otolaryngologists to make early diagnoses and correct treatment by MRI and CT scan. Prompt surgical intervention of endoscopic transnasal sphenoidectomy is a quite safe, effective, and minimally invasive method for patients.

幼童突发性失明是鼻小窦腔粘液瘤引起的唯一症状
背景:与成人相比,蝶窦粘液瘤(SSM)在儿童中是一种相对罕见的疾病,发病率占所有副鼻窦粘液瘤的 1%至 3%。由于最初的症状往往不尽相同,导致失明的鼻窦粘液瘤很少见。病例介绍:我们在此描述了一例不寻常的病例,患者是一名 9 岁女孩,因小而孤立的 SSM 导致急性视力丧失。患者因右眼失明首先就诊于眼科医生。眼眶磁共振成像扫描显示,患者被怀疑诊断为 SSM。随后,患者被转诊至我科,并接受了内窥镜蝶鞍切除术和视神经减压术。令人惊讶的是,她的视力在术后立即得到缓解,并在术后 20 个月的随访期间得到显著改善。结论:据我们所知,临床医生(包括神经科医生、眼科医生和耳鼻喉科医生)必须更好地了解儿科的 SSM,才能通过核磁共振成像和 CT 扫描做出早期诊断和正确治疗。对患者来说,及时进行内窥镜下经鼻鼻翼切除术是一种相当安全、有效和微创的手术干预方法。
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