Issue N# 1 - 2017
Trigeminal neuralgia: An unexpected complication of pterygopalatine fossa mucocele
Authors : Piché M, Nadeau S. (Québec)
Ref. : Rev Laryngol Otol Rhinol. 2017;138,1:31-32.
Article published in french
Downloadable PDF document french
Introduction and case description: Paranasal sinus mucoceles are uncommon masses caused by a trauma, surgery, chronic inflammatory disease or infection. Although they are benign lesions, their localisation and degree of expansion into surrounding structures can cause a variety of symptoms. Only a few cases of pterygopalatine fossa mucoceles have been reported in the literature and neurologic symptoms are also very rare. Methods: Case report and review of the literature. Discussion: We presented a complication of a mucocele in a 19-year-old boy. He previously underwent Lefort I maxillary osteotomy and had unexpected and persistent symptoms of trigeminal neuralgia involving the right maxillary division. CT scan and MRI revealed a right pterygopalatine mass, extending in the pterygomaxillary fossa and leading to a compression of the trigeminal nerve. He underwent an endoscopic endonasal surgery and marsupialisation of the lesion. Pathology confirmed the diagnosis of mucocele. The post-operative course was free of complication and the patient noted a completed resolution of his facial pain. Conclusion: Although this is a very rare situation, a mucocele should be included in the differential diagnosis of a mass of the pterygopalatine fossa in a patient with a clinical presentation of trigeminal neuralgia.
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