PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of skullbasesurgInstructions for AuthorsSubscribe to Skull BaseAbout Skull BaseEditorial BoardThieme Medical PublishingSkull Base An Interdisciplinary Approach ...
 
Skull base surgery. 1994 July; 4(3): 169–175.
PMCID: PMC1661801

Temporary Unilateral Amaurosis with Pneumosinus Dilatans of the Sphenoid Sinus

Abstract

Pneumosinus dilatans (PSD), first described by Meyes in 1898, is an abnormal dilatation of one or more of the paranasal sinuses without bony erosion. The term sinus pneumocele indicates the presence of bony erosion. Review of the literature from 1968 to 1992 revealed 24 cases of idiopathic PSD and 17 cases of pneumocele of various paranasal sinuses. PSD occurred most commonly in the frontal sinus. Males were more often affected than females. The average age for males ranged from 16.5 for the maxillary sinus to 35.5 years for the sphenoid sinus. Pneumoceles occurred most commonly in the maxillary sinus. The average age for males ranged from 29 years for the frontal sinus and 47 years for the ethmoid sinus. Two patients (1 pneumocele and 1 PSD) had a temporary loss of vision. We report the case of a 37-year-old mountain climber who experienced temporary loss of vision in his left eye above 3000 m. Vision returned below 2000 m. High resolution computed tomography scan revealed pneumosinus dilatans of the sphenoid sinus with dehiscence of the optic canal on the left side. Endonasal microendoscopic resection of the anterior wall of the left sphenoid sinus was performed. The patient has remained symptom-free after 2 years of follow-up. Pneumosinus dilatans should always be considered in the differential diagnosis of sudden visual loss associated with atmospheric pressure changes.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.6M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Images in this article

Click on the image to see a larger version.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Lombardi G, Passerini A, Cecchini A. Pneumosinus dilatans. Acta Radiol Diagn (Stockh) 1968 Nov;7(6):535–542. [PubMed]
  • Dhillon RS, Williams DC. Pneumosinus dilatans. J Laryngol Otol. 1987 Aug;101(8):828–832. [PubMed]
  • Lloyd GA. Orbital pneumosinus dilatans. Clin Radiol. 1985 Jul;36(4):381–386. [PubMed]
  • van Schayck R, Niedeggen A. Pneumosinus dilatans after prolonged cerebrospinal fluid shunting in young adults with cerebral hemiatrophy. A report of two cases and review of the literature. Neurosurg Rev. 1992;15(3):217–223. [PubMed]
  • Seur NH, Kooman A. Arachnoid cyst of the middle fossa with paradoxical changes of the bony structures. Neuroradiology. 1976;12(3):177–183. [PubMed]
  • Dross PE, Lally JF, Bonier B. Pneumosinus dilatans and arachnoid cyst: a unique association. AJNR Am J Neuroradiol. 1992 Jan-Feb;13(1):209–211. [PubMed]
  • Strottmann JM, Williams DW., 3rd Pneumosinus dilatans and arachnoid cyst. AJNR Am J Neuroradiol. 1992 Nov-Dec;13(6):1672–1673. [PubMed]
  • Spoor TC, Kennerdell JS, Maroon JC, Hepler R, Krohel G. Pneumosinus Dilatans, Klippel-Trenaunay-Weber syndrome, and progressive visual loss. Ann Ophthalmol. 1981 Jan;13(1):105–108. [PubMed]
  • Stretch JR, Poole MD. Pneumosinus dilatans as the aetiology of progressive bilateral blindness. Br J Plast Surg. 1992 Aug-Sep;45(6):469–473. [PubMed]
  • Wiggli U, Oberson R. Intrakranielle Hyperplasie spheno-ethmoidaler Zellen als Zeichen eines Meningeoms. Schweiz Med Wochenschr. 1973 Oct;103(43):1492–1499. [PubMed]
  • Leonardi M, Fabris G. Le pneumosinus dilatans, signe radiologique direct des méningiomes de l'angle antérieur du chiasma. Ann Radiol (Paris) 1976 Dec;19(8):803–806. [PubMed]
  • Seutin B, Cornelis G, Vandresse JH. Signes précoces du méningiome de l'angle antérieur du chiasma: "pneumosinus dilatans et hyperostose" et "blistering". J Belge Radiol. 1979;62(6):587–595. [PubMed]
  • Hirst LW, Miller NR, Allen GS. Sphenoidal pneumosinus dilatans with bilateral optic nerve meningiomas. Case report. J Neurosurg. 1979 Sep;51(3):402–407. [PubMed]
  • Hirst LW, Miller NR, Hodges FJ, 3rd, Corbett JJ, Thomspson S. Sphenoid pneumosinus dilatans. A sign of meningioma originating in the optic canal. Neuroradiology. 1982;22(4):207–210. [PubMed]
  • Reicher MA, Bentson JR, Halbach VV, Lufkin R, Hepler RS. Pneumosinus dilatans of the sphenoid sinus. AJNR Am J Neuroradiol. 1986 Sep-Oct;7(5):865–868. [PubMed]
  • Jeans WD. Pneumosinus dilatans as a cause of variable unilateral proptosis. J Laryngol Otol. 1979 Mar;93(3):317–317. [PubMed]
  • Urken ML, Som PM, Lawson W, Edelstein D, Weber AL, Biller HF. Abnormally large frontal sinus. II. Nomenclature, pathology, and symptoms. Laryngoscope. 1987 May;97(5):606–611. [PubMed]
  • Borelli G, Torsello G, Gualtieri G. Considerazioni su un caso di pneumosinus dilatans sfenoidale. Radiol Med. 1979 Oct;65(10):735–739. [PubMed]
  • Candan S, Muhtar H, Ciftçi A. Der Pneumosinus dilatans frontalis. Laryngorhinootologie. 1990 Oct;69(10):552–553. [PubMed]
  • Chan FL, Chow SK, Sham JS. Infratemporal pneumatocele arising from maxillary sinus. Clin Radiol. 1992 Jan;45(1):27–30. [PubMed]
  • Gray RF, Barton RP. Pneumosinus dilatans as a cause of variable unilateral proptosis. J Laryngol Otol. 1978 Jul;92(7):623–625. [PubMed]
  • Jarvis JF. Pneumocele of the frontal and sphenoidal sinuses. J Laryngol Otol. 1974 Aug;88(8):785–793. [PubMed]
  • Meyer-Breiting E. Spontane Siebbeinpneumozele auf dem Boden einer chronisch-polypösen Sinusitis maxillaris und Ethmoiditis. HNO. 1978 Oct;26(10):350–352. [PubMed]
  • Meyers AD, Burtschi T. Pneumocele of the maxillary sinus. J Otolaryngol. 1980 Aug;9(4):361–363. [PubMed]
  • Morrison MD, Tchang SP, Maber BR. Pneumocele of the maxillary sinus. Report of a case. Arch Otolaryngol. 1976 May;102(5):306–307. [PubMed]
  • Noyek AM, Zizmor J. Pneumocele of the maxillary sinus. Arch Otolaryngol. 1974 Aug;100(2):155–156. [PubMed]
  • Noyek AM, Zizmor J, Morrison MD, Vines FS, Shaffer K. The radiologic diagnosis of pneumocele of the maxillary sinus. J Otolaryngol Suppl. 1977;6(3):17–21. [PubMed]
  • Som PM, Sachdev VP, Biller HF. Sphenoid sinus pneumocele. Report of a case. Arch Otolaryngol. 1983 Nov;109(11):761–764. [PubMed]
  • Vines FS, Bonstelle CT, Floyd HL. Proptosis secondary to pneumocele of the maxillary sinus. Neuroradiology. 1976 May 31;11(2):57–59. [PubMed]
  • Wolfensberger M, Herrmann P. The pathogenesis of maxillary sinus pneumoceles. Arch Otolaryngol Head Neck Surg. 1987 Feb;113(2):184–186. [PubMed]
  • Zizmor J, Bryce M, Schaffer SL, Noyek AM. Pneumocele of the maxillary sinus. A second case report. Arch Otolaryngol. 1975 Jun;101(6):387–388. [PubMed]
  • Urken ML, Som PM, Lawson W, Edelstein D, McAvay G, Biller HF. The abnormally large frontal sinus. I. A practical method for its determination based upon an analysis of 100 normal patients. Laryngoscope. 1987 May;97(5):602–605. [PubMed]
  • Tovi F, Gatot A, Fliss DM. Air cyst of the maxillary sinus (pneumosinus dilatans, pneumocoele). J Laryngol Otol. 1991 Aug;105(8):673–675. [PubMed]
  • Macialowicz T. Przypadek odmy zatokowej rozprezajacej zatoki klinowej i komórek sitowych tylnych (Pneumosinus dilatans) Pol Przegl Radiol Med Nukl. 1969 Jul-Aug;33(4):385–391. [PubMed]
  • Renn WH, Rhoton AL., Jr Microsurgical anatomy of the sellar region. J Neurosurg. 1975 Sep;43(3):288–298. [PubMed]
  • Sugita K, Hirota T, Iguchi I, Kageyama N, Ito A. Transient amaurosis under decreased atmospheric pressure with sphenoidal sinus dysplasia. Case report. J Neurosurg. 1977 Jan;46(1):111–114. [PubMed]
  • Bourdial J. Le pneumosinus dilatans du sinus frontal. Ann Otolaryngol Chir Cervicofac. 1970 Jul-Aug;87(7):405–436. [PubMed]
  • Komori E, Sugisaki M. Ectopic pneumosinus maxillaris dilatans. A case report. J Craniomaxillofac Surg. 1988 Jul;16(5):240–242. [PubMed]
  • Legent F, Bordure P, Korb G, Calais C, Beauvillain C. Pneumosinus dilatans. Résultat à long terme des ostéoplasties modelantes. Ann Otolaryngol Chir Cervicofac. 1991;108(1):30–33. [PubMed]
  • Pospisil OA, Balmer MC. Pneumosinus dilatans. Br J Oral Maxillofac Surg. 1988 Oct;26(5):375–380. [PubMed]
  • Prott W. Pneumosinus dilatans der Stirnhöhlen. Ein Beitrag zur Atiologie und Therapie dieser Erkrankung. Laryngol Rhinol Otol (Stuttg) 1977 Mar;56(3):277–282. [PubMed]
  • Smith IM, Maran AG, von Haacke NP. Pneumosinus dilatans. Ann Otol Rhinol Laryngol. 1987 Mar-Apr;96(2 Pt 1):210–212. [PubMed]
  • Steinberg D. Zur Klinik und Genese des Pneumosinus dilatans frontalis. Z Laryngol Rhinol Otol. 1969 Dec;48(12):909–916. [PubMed]
  • Williams JP, Shawker TH, Lora J. Pneumosinus dilatans of the sphenoid sinus. Bull Los Angeles Neurol Soc. 1975 Apr;40(2):45–48. [PubMed]
  • Benedikt RA, Brown DC, Roth MK, Geyer CA, Ghaed VN. Spontaneous drainage of an ethmoidal mucocele: a possible cause of pneumosinus dilatans. AJNR Am J Neuroradiol. 1991 Jul-Aug;12(4):729–731. [PubMed]

Articles from Skull Base Surgery are provided here courtesy of Thieme Medical Publishers