Bilateral pneumosinus dilatans of the sphenoid sinuses causing visual loss

The purpose of this paper is to discuss the rare presentation of pneumosinus dilatans (PDS) of the sphenoid sinuses in a pediatric patient manifesting as acute visual loss, and his successful treatment with surgical intervention.A total of 29 cases of sphenoid sinuses in the literature were reviewed.11 patients (37.93%) were classified as having idiopathic disease. 22 patients (75.86%) presented with visual loss as their chief complaint. All 3 patients with idiopathic PDS that underwent sphenoidotomy had resolution of their symptoms.When symptomatic sphenoid sinus PDS is diagnosed, endoscopic sphenoidotomy should be considered as primary treatment.