Pneumosinus Dilatans: A Myriad of Symptomology

Sphenoidal pneumosinus dilatans associated compressive optic neuropathy: A case series of four adolescent patients

Visual impairment caused by pneumosinus dilatans (PSD) among adolescents is a rare condition, which is associated with a high blinding rate due to the lack of clinical manifestations and effective treatment. The use of magnetic resonance imaging (MRI) and computed tomography (CT) may be helpful in diagnosis of PSD, and the endoscopic transnasal optic nerve decompression (ETOND) can improve the vision of PSD patients with visual impairments. This case series report detailing the diagnosis and treatment of visual impairments caused by PSD has improved clinicians' understanding of this disease and helped reduce misdiagnoses and missed diagnoses. This article also highlighted the efficacy of this less invasive technique in managing optic nerve compression caused by sphenoidal pneumosinus dilatans (SPSD) in pediatric patients. In addition, this report proposed a novel aspect to explore the etiology of PSD and suggested the significance of proper terminology use when describing different PSD conditions, as well as possible future mechanisms explorations.

Pneumosinus Dilatans of the Frontal and Ethmoidal Sinuses Revealed by Conscience Disorder and Respiratory Distress: Case Report and Literature Review

An abnormal enlargement of the air-filled paranasal sinuses is referred to as pneumosinus dilatans. Typically discovered incidentally through radiological examinations, it infrequently manifests as cosmetic, neurological, ocular, or rhinological pathologies. Thorough evaluation for associated conditions is essential in patients with pneumosinus dilatans, including meningiomas of the anterior skull base or the optic nerve sheath. In our work, we report a 75-year-old female patient who presented with dysarthria and lower facial asymmetry. The computed tomography (CT) scan revealed pneumosinus dilatans of the frontal and ethmoidal sinuses with subfalcine herniation. During hospitalization, the patient presented with conscience disorder secondary to ischemic stroke and respiratory distress secondary to aspiration pneumonia. In our work, we also discuss reported cases of the English literature.