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The patient was diagnosed by the Pneumology Service with obstructive sleep apnoea syndrome (OSAS) under treatment with continuous positive airway pressure (CPAP). He was sent to our Otorhinolaryngology Service for intolerance to the CPAP due to nasal obstruction.</p><p id="par0010" class="elsevierStylePara elsevierViewall">In the physical exam, rhinoscopy revealed anterior septal deviation towards the left nostril. Using nasofibrolaryngoscopy a very large bulky mass was seen in the cavum. A CAT scan (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) was requested as a complementary test; it showed erosion of the floor of the sella turcica with a mass that occupied the cavum area and left nostril, which could correspond to a tumour in the sella turcica or cavum. Faced with this diagnostic doubt, an NMR was recommended (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). In the NMR T2 sequence, intracranial content was seen to protrude due to a bone defect (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), which was homogeneously hyperintense. This suggested great fluid content (CSF), and a diagnosis of sphenoid meningocele was finally established. Consequently, our service decided to wait and observe, and the patient was sent to the Neurosurgical Service for assessment.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: de la Fuente Cañibano R, Ruiz González M. Causa infrecuente de insuficiencia ventilatoria nasal. Acta Otorrinolaringol Esp. 2014;65:273.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 740 "Ancho" => 950 "Tamanyo" => 89424 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">CAT scan: Erosion of the floor of the sella turcica with occupation of the cavum or left nostril.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 754 "Ancho" => 950 "Tamanyo" => 107066 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">NMR: Bone defect with image of intracranial protrusion suggesting great water content, compatible with sphenoid meningocele.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735735/0000006500000004/v1_201408141153/S2173573514000842/v1_201408141153/en/main.assets" "Apartado" => array:4 [ "identificador" => "5869" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in otorhinolaryngology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735735/0000006500000004/v1_201408141153/S2173573514000842/v1_201408141153/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173573514000842?idApp=UINPBA00004N" ]
Journal Information
Vol. 65. Issue 4.
Pages 273 (July - August 2014)
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Vol. 65. Issue 4.
Pages 273 (July - August 2014)
Images in Otorhinolaryngology
A Rare Cause of Nasal Obstruction
Causa infrecuente de insuficiencia ventilatoria nasal
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Rebeca de la Fuente Cañibano
, Manuel Ruiz González
Corresponding author
Servicio de Otorrinolaringología y Patología Cérvico-Facial, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
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