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Sphenoid sinus
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Sphenoid sinus

I will try to be shot & to the point!  47 yr old female that normally never goes to the Doctors as I am  normally healthy and very active, though the last year has been weird, last couple of weeks hell.

ENT ordered MRI/MRA saying problems sound vascular: pulse sound in ears & pressure feeling in R ear, this is X's 1 year and for about 2 weeks have had a dull face/back of eyes/top of head headache 24/7 (I never get headaches), light sensitive, dead tired and just not with it (not my normal active sassy self).  The dull headache along with red, dry, scratcy, heavy feeling eyes and tired...  I assumed were side effects of Xalatan drops for newly dx'd probable Glaucoma (been taking drops for 1 month now).  Ophthalmologist said give two more weeks to get used to.  I also have postual hypotension x's about 6 months and am salting, do not want to use steroids unless start passing out.

Brain/IAC's MRI/MRA says all is fine for vascular, IAC's and ears 100% at 40db.  ENT to recomment to PCP that I see Neurologist and then cardiologist.  ENT did not mention in his report to PCP (or to me) any of the following second part of the radiology report, only the good new that I do not have any problems with ears, hearing or vascular issues in my head.  I always get copies of any test done for my records, the area we live in is knowm for Doctors that come and go, retire, pass...

#1 on radiology report: all is fine as stated above
#2 on radiology report: see following

Probable mucocele in the nondependent portion of the sphenoid sinus should be evaluated by direct visualization.

There is a lobulated 1.1 x 1.2 cm soft tissue mass anteriorly in the left sphenoid sinus  This is isointense to white matter on the T1W images, hyperintense on the T2W images and does not demonstrate any evidence of enhancement.  This probably represents a mucocele, but should be evaluated by direct visualization.  The remainder of the visualized paranasal sinuses do not demonstate any evidence of abnormality.

I faxed a copy of this to PCP and also dropped a copy off to  Ophthalmologists office.
I am confused as to no mention of #2  on the radiology report to PCP or even saying something to me, this all happened last week. I did look at CD and saw what radiologist is refering to,  in one view there are two little branches that branch to something that looks like (don't laugh too hard) "brain matter" on the side, I don't know, wish I could add photo(s) but could not figure how to get off CD :(

Anyway, wondering why this was not brought up and being left out and off (when radiologist recommends visual), I feel at a loss, not my normal in control self I guess. I will be calling tomorrow to make apppointment with PCP  to follow up on this... In the mean time I am feeling pretty lousy and wandering

Is it because 1.1 X 1.3 cm considered small in this area?  
wait & see? but why not tell me or PCP so he can wait & see/follow up?
Could this maybe be a cause for probable Glaucoma diag ?  


Any information on this subject you are able to provide would be greatly appreciated,
Cis
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3 Comments Post a Comment
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Avatar_f_tn
Hi,

How are you?
Mucoceles are defined as mucus filled cyst surrounded by mucus secreting epithelium.
Mucocele of the sphenoid sinus occurs very rarely. Mucoceles are more common in the maxillary sinus.
A sphenoid sinus mucocele can produce symptoms of sub occipital headaches and vision loss.
Mucoceles are generally sterile although occasionally they can get infected and then they cause pain.
It is possibly that your headaches and vision problems are related to the mucocele in the sphenoid sinus. Please discuss this with your treating doctor. Keep us posted!

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Avatar_f_tn
Thank you very, very much :) Will make appt with PCP after 1pm  for follow up and will post back.
Finally found site with great MRI pictures to compare, laughing about brain matter?
try temporal lobe "brain matter"
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Avatar_f_tn
Good grief!

It has been a long two months of which about a month and a half I was the walking dead, non functioning. In fact my computer crashed and just got around to ordering a new one.

Neurologist says I have tension headaches and took me off the glaucoma drops telling me someone has to be in that less than 1%  (side effects I was having.)  Within 3 weeks I was feeling much better, able to function anyway. Will have my 3rd potassium test this week as it has been slightly elevated.

Neuro talked to Ophtho who looked at MRI/MRA who in turn talked to ENT about re looking at this thing in my sphenoid sinus.  The ENT had said it was “not clinically relevant” back when.  Now ENTs office is saying basically that was not what they were looking for/not reason for MRI/MRA and these mucoceles show up in 50% of MRIs when looking for something else. They had believed this to be a retention cyst based on looking at the MRI  hence “not clinically relevant”

ENT to look at/scope me mid this week

Meanwhile my headaches have gone from 24/7 dull to not 24/7 and for about 3 weeks now have had dull neck and shoulder pain but woke up this morning with a killer headache at the back base of head.  I have also had a lump in the side of my neck now for about a month it is about the size of a penny, have had this before but it always went away and have never seen a Doctor for it.


I am truly discouraged by the medical in this area and after the scope is done and I am told the results will ask for a referral to UPMC for a 2nd opinion (so notes and tests are shared and don’t have to start from the beginning) and treatment if needed.  I have lost all respect and confidence with this ENT  to trust he is paying attention or even reading the Radiologists report or recommendations! I could deal with his rattlesnake bed side manner as I have a bold personality , that is if I felt him a good Doctor!

I am not one to run to the Doctor for anything, in fact old PCP once said sarcastically see you in 2-3 years! Really feeling I am a pain in the *** with all my physical complaints but something “just ain’t right”
The positive, in my own mind anyway is that I have put on 15 lbs in the last two months (now in normal range) easing my mind of the big C .
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