A case of orbital tip syndrome caused by sphenoid sinus mucoceles

Sphenoid sinus mucoceles are benign lesions of the sphenoid sinus, but they can cause a decrease in vision and ocular motor paralysis.

We report on the observation of a patient who presented with decreased vision and left upper eyelid ptosis. Preoperative radiological examination suggested the sphenoid sinus mucocele. The patient underwent endoscopic marsupialization of the sphenoid sinus mucocele. Five days postoperatively, there was an improvement in vision and visual fields; fifty days postoperatively, both ocular movement and eyelid movement of the left eye returned to normal, with vision improving to 0.4.

Sphenoid sinus mucoceles can cause optic nerve and superior branch of the oculomotor nerve palsy, leading to decreased vision and upper eyelid ptosis. Timely endoscopic nasal surgery can result in the recovery of nerve function.

Sphenoid sinus mucoceles causing orbital apex syndrome require timely surgical treatment to prevent permanent neurological damage.