{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T10:48:35Z","timestamp":1777978115718,"version":"3.51.4"},"reference-count":75,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Isolated sphenoid sinus fungal mucoceles are extremely rare and potentially associated with visual disturbances, cranial nerve (CN) deficits, or pituitary dysfunction. Their initial symptoms are often absent or nonspecific, and routine examination offers little information, resulting in diagnostic and therapeutic delays. A high index of suspicion and a thorough understanding of their clinical presentation, neuroradiological features, microbiological implications, and complication profile are crucial for early diagnosis and prompt management. We, herein, analyze a series of consecutive cases of isolated sphenoid sinus fungal mucoceles whom we treated, add to the currently existing published cases, and review the pertinent literature.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>From the databases of endoscopic endonasal skull base and rhinological surgical procedures maintained by our groups, all cases with isolated sphenoid sinus fungal mucoceles were retrieved and included in the study. Clinical and radiological findings, histopathologic evidence of fungal rhinosinusitis, culture results, clinicopathological designation, treatment details, and outcome of CN neuropathies were analyzed.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>Headache was the most common symptom (seven cases). Oculomotor (three cases) and abducens (two cases) nerve palsies were encountered in five out of eight patients. Visual loss was seen in two cases. Hypopituitarism was seen in one case. All patients underwent endoscopic endonasal wide bilateral sphenoidectomy. CN palsies improved in four out of five cases.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Endoscopic endonasal wide sphenoidectomy is the surgical treatment of choice and should be performed in a timely manner to prevent permanent sequelae. Histopathological and microbiological examination findings should both be obtained as they dictate the next steps of therapeutic intervention.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_849_2024","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T07:01:15Z","timestamp":1732863675000},"page":"444","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Isolated sphenoid sinus fungal mucoceles: A rare entity with a high propensity for causing neurological complications"],"prefix":"10.25259","volume":"15","author":[{"given":"Marwa","family":"Ibrahim","sequence":"first","affiliation":[{"name":"Department of Tropical Medicine, Faculty of Medicine, Alexandria University, Alexandria, Egypt"},{"name":"Department of Infection Control, Ibn Sina Hospital, Al-Sabah Medical Area, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marwan","family":"Alqunaee","sequence":"additional","affiliation":[{"name":"Department of ENT, Zain Hospital, Al-Sabah Medical Area, Kuwait City, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mustafa","family":"Najibullah","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ibn Sina Hospital, Al-Sabah Medical Area, Kuwait City, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zafdam","family":"Shabbir","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ibn Sina Hospital, Al-Sabah Medical Area, Kuwait City, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Waleed A.","family":"Azab","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ibn Sina Hospital, Al-Sabah Medical Area, Kuwait City, Kuwait"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2024,11,29]]},"reference":[{"key":"10.25259\/SNI_849_2024\/ref-1","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1259\/dmfr\/92903178","article-title":"Sphenoid sinus mucocele causing third nerve paralysis: CT and MR findings","volume":"33","author":"Akan","year":"2004","journal-title":"Dentomaxillofac Radiol"},{"key":"10.25259\/SNI_849_2024\/ref-2","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1016\/j.jaci.2013.02.036","article-title":"Endotypes and phenotypes of chronic rhinosinusitis: A PRACTALL document of the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma & Immunology","volume":"131","author":"Akdis","year":"2013","journal-title":"J Allergy Clin Immunol"},{"key":"10.25259\/SNI_849_2024\/ref-3","doi-asserted-by":"crossref","first-page":"11902","DOI":"10.1038\/s41598-021-89995-7","article-title":"Isolated sphenoid sinus opacification is often asymptomatic and is not referred for otolaryngology consultation","volume":"11","author":"Ashida","year":"2021","journal-title":"Sci Rep"},{"key":"10.25259\/SNI_849_2024\/ref-4","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.jaip.2016.05.004","article-title":"Phenotypes and emerging endotypes of chronic rhinosinusitis","volume":"4","author":"Bachert","year":"2016","journal-title":"J Allergy Clin Immunol Pract"},{"key":"10.25259\/SNI_849_2024\/ref-5","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1177\/019459989411100508","article-title":"Diagnosis of allergic fungal sinusitis","volume":"111","author":"Bent","year":"1994","journal-title":"Otolaryngol Head Neck Surg"},{"key":"10.25259\/SNI_849_2024\/ref-6","doi-asserted-by":"crossref","first-page":"13","DOI":"10.2500\/105065800781602993","article-title":"Isolated sphenoid sinus lesions","volume":"14","author":"Cakmak","year":"2000","journal-title":"Am J Rhinol"},{"key":"10.25259\/SNI_849_2024\/ref-7","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1148\/radiographics.14.1.8128053","article-title":"Image interpretation session: 1993. 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