Three cases of isolated mucoceles and one case of an Aspergillus infection in the sphenoid sinus with orbital signs and symptoms.

Four patients with an isolated sphenoid lesion: three with a mucocele and one with an Aspergillus infection of the sphenoid sinus in whom the orbital impairment had a rhinogenic cause, are described. They all presented with one or more of the following features: visual loss, motility disturbances, visual field defects, and sensitivity loss of the infraorbital nerve. In one patient, optic disc edema was seen. Diagnostic imaging technologies such as computer tomography (CT) and magnetic resonance (MRI) make an early diagnosis possible but nevertheless, very large mucoceles with major functional loss were detected at a late stage of the disease. The Aspergillus infection was detected at an early stage without delay because of its specific appearance on CT and MRI. The signs and symptoms of these lesions are more striking in the orbital and neuro-ophthalmological field than in the ear-nose-throat (ENT) field, but nevertheless, primary treatment should be marsupialization by an ENT-surgeon.