Pneumosinus Dilatans and Associated Visual Impairments
Summary
Pneumosinus dilatans is characterised by an abnormal enlargement of one or more paranasal sinuses without evidence of mucosal disease or bony erosion. Although often detected incidentally on imaging, this rare condition may give rise to neurological, cosmetic and, importantly, visual sequelae. Expansion of the frontal, ethmoidal or sphenoidal sinus can distort adjacent orbital anatomy, leading to optic canal narrowing, optic nerve compression and consequent visual field defects or reduced acuity. Patients may present with proptosis, diplopia, headaches or insidious vision loss. Diagnosis relies on high-resolution computed tomography and magnetic resonance imaging to delineate sinus dimensions and assess optic nerve relationships. Management strategies range from conservative observation in asymptomatic cases to endoscopic or open surgical decompression in the presence of symptomatic optic neuropathy or intracranial mass effect. A multidisciplinary approach involving otolaryngology, neurosurgery and ophthalmology is essential to balance restoration of visual function against potential operative risks. Advances in image-guided techniques and minimally invasive fenestration have improved outcomes, yet long-term data remain sparse. Ongoing research focuses on elucidating underlying mechanisms of sinus over-pressurisation and defining optimal timing for intervention to prevent irreversible visual impairment.
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Pneumosinus Dilatans and Associated Visual Impairments publication trend
The graph below shows the total number of articles in pneumosinus dilatans and associated visual impairments across all publications each year (not limited to Nature Index journals).
Technical terms
Pneumosinus dilatans: Abnormal over-expansion of a paranasal sinus exceeding its normal anatomical boundaries without mucosal or osseous pathology.
Paranasal sinuses: Air-filled cavities within the craniofacial bones that communicate with the nasal cavity.
Compressive optic neuropathy: Visual impairment resulting from external pressure on the optic nerve leading to axonal dysfunction.
Endoscopic sinus surgery: Minimally invasive technique employing nasal endoscopes to access and decompress diseased or expanded sinuses.
Subfalcine herniation: Displacement of cerebral hemispheric tissue beneath the falx cerebri due to intracranial pressure shifts.
References
- Pneumosinus Dilatans of the Frontal and Ethmoidal Sinuses Revealed by Conscience Disorder and Respiratory Distress: Case Report and Literature Review. Cureus (2024).
- Pneumosinus dilatans: Experiencia clnica y revisin del tema. Revista de otorrinolaringología y cirugía de cabeza y cuello (2009).
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