Sphenoid Sinus Mucocele (Anterior Clinoid Variant) Mimicking Diabetic Ophthalmoplegia and Retrobulbar Neuritis

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Two patients (two men, 56 and 59 years old) had sphenoid sinus mucocele originating in the anterior clinoid process. In one case the mucocele initially mimicked diabetic ophthalmoplegia with pupil-sparing palsy of the oculomotor (third) nerve. After resolution of the palsy, severe visual loss developed with minimal recovery of vision after surgery. The second patient had recurrent episodes of retrobulbar optic neuropathy with optic atrophy and decreased vision. Visual loss from sphenoid sinus mucoceles is usually associated with a poor prognosis if surgical treatment is delayed more than seven to ten days.

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This study was presented in part at the 18th Annual Frank B. Walsh Society Meeting, Seattle, Washington, Feb. 21, 1986. Dr. Johnson is a Heed Foundation Fellow (1985−1986).

Reprint requests to Robert S. Hepler, M.D., Jules Stein Eye Institute, 800 Westwood Plaza, Los Angeles, CA 90024.

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Copyright © 1986 Elsevier Inc. All rights reserved.