[Sphenoid arachnoidocele: report of one case]

To define a diagnostic strategy of a sphenoid sinus lesion and the management of CSF fluid leak in the case of a sphenoid arachnoidocele.

A 70-year-old woman exhibited a sphenoidal sinus opacity which was discovered on the assessment of chronic headaches. It was labelled sphenoid mucocele. A cerebrospinal fluid leak occurred when the marsupialization was made. After an assessment of additional imaging (MRI, CTscan), the diagnosis of sphenoid arachnoidocele was retained.

The leak was repaired by navigated endoscopic endonasal surgery. We used a multilayer reconstructive technique with autologous materials (abdominal fat, fascia of muscle, middle turbinate) and fibrin glue. With a decline of eighteen months no rhinorrhea was noted.

Sphenoid arachnoidocele is a rare disease. This case shows that it's essential to know the differential diagnosis sphenoid sinus lesions and how to repair an osteomeningeal leak.