title: Unusual presentation of an asymptomatic pseudomeningocele within the sphenoid sinus.
abstract: OBJECTIVE
  We report the rare case of a 55-year-old woman with an asymptomatic left sphenoid sinus pseudomeningocele mimicking a mucocele.
  
  
  METHODS
  A 55-year-old woman was found to have an incidental mass in the left sphenoid sinus on computed tomography. Magnetic resonance imaging confirmed the presence of a mucocele. A left endoscopic sphenoidotomy was performed to drain the mucocele. Despite an anatomical puncture through a stenosed sphenoid ostium, alarmingly, the opening leaked cerebrospinal fluid. A dehiscent lateral wall was identified with a dural opening communicating with the sphenoid sinus. This was immediately repaired with a free nasal septal mucosal graft. Six months post-operatively, the patient remained free from cerebrospinal fluid leakage.
  
  
  CONCLUSIONS
  Pseudomeningoceles are extremely rare in the absence of trauma or iatrogenic injury. Surgeons should be alert to their presence as they can mimic a unilateral mucocele or nasal polyp. Endoscopic management lends itself to a single-stage repair.
authors.affiliation: Department of Otolaryngology, Tameside Hospital, Ashton-Under-Lyne, UK.
authors.forename: K J
authors.initials: KJ
authors.lastname: McNamara
authors.affiliation: Department of Otolaryngology, Tameside Hospital, Ashton-Under-Lyne, UK.
authors.forename: R P
authors.initials: RP
authors.lastname: Exley
authors.affiliation: Department of Rhinology, Central Manchester Foundation Trust, UK.
authors.forename: S
authors.initials: S
authors.lastname: Khwaja
authors.affiliation: Department of ENT, University of Manchester, Manchester Academic Health Science Centre, Central Manchester University Foundation Trust, UK.
authors.forename: R K
authors.initials: RK
authors.lastname: Bhalla
mesh_terms: D003287:Contrast Media; D003937:Diagnosis, Differential; D004322:Drainage / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009078:Mucocele / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D013101:Sphenoid Sinus / Q000002:abnormalities* / Q000000981:diagnostic imaging* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media