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Introduction <p>Sinonasal cholesteatomas are rare slow-growing lesions usually misdiagnosed preoperatively. Among the paranasal sinuses, sphenoid sinus is the rarest to site for its occurrence. Although benign, the keratinising squamous epithelium-lined sac with desquamated debris can expand leading to potentially life-threatening complications if not managed early enough. To ensure complete disease clearance and to eliminate risk of recurrence, it is important to remove the cyst lining and avoid/delay cavity obliteration.</p> Case Report <p>Hereby, we present a case of a 17-year-old lady, who presented with diplopia and foul-smelling nasal discharge with an unremarkable nasal endoscopy. On radiology, a soft tissue lesion was found in the sphenoid sinus causing erosion of its bony walls and compressing the optic nerve. During functional endoscopic sinus surgery, the sinus was found to be widened and filled with caseous necrotic material which was dissected off the dehiscent optic nerve sheath. On histopathology, it was found to be consistent with rhinits caseosa. In the follow-op visit, the patient reported normal vision.</p> Conclusion <p>In this case, as there was early presentation, prompt efficient management could be carried out, evading any unforeseen complications like bone erosion or skull base osteomyelitis, which may prove fatal.</p>

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Sphenoid Sinus Cholesteatoma: A Rare but Potentially Debilitating Condition – A Case Report with Literature Review

  • 期刊论文

  • 发表日期：

    2025年11月1日

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  • Pooja Nakhat Jain,
  • Abhinav Agarwal,
  • Nikhil Arora ,
  • Anshika Harit ,
  • Ditixa Patel

摘要

Introduction

Sinonasal cholesteatomas are rare slow-growing lesions usually misdiagnosed preoperatively. Among the paranasal sinuses, sphenoid sinus is the rarest to site for its occurrence. Although benign, the keratinising squamous epithelium-lined sac with desquamated debris can expand leading to potentially life-threatening complications if not managed early enough. To ensure complete disease clearance and to eliminate risk of recurrence, it is important to remove the cyst lining and avoid/delay cavity obliteration.

Case Report

Hereby, we present a case of a 17-year-old lady, who presented with diplopia and foul-smelling nasal discharge with an unremarkable nasal endoscopy. On radiology, a soft tissue lesion was found in the sphenoid sinus causing erosion of its bony walls and compressing the optic nerve. During functional endoscopic sinus surgery, the sinus was found to be widened and filled with caseous necrotic material which was dissected off the dehiscent optic nerve sheath. On histopathology, it was found to be consistent with rhinits caseosa. In the follow-op visit, the patient reported normal vision.

Conclusion

In this case, as there was early presentation, prompt efficient management could be carried out, evading any unforeseen complications like bone erosion or skull base osteomyelitis, which may prove fatal.