23 Pneumosinus Dilatans

Ing Ping Tang, Yves Brand and Prepageran Narayanan

Abstract

Pneumosinus dilatans (PD) of the frontal sinus is a very rare craniofacial malformation. Less than 150 cases were reported in the literature since 1955. Meyes was the first person to describe this condition in 1898 and later Benjamin renamed it PD in 1918. Urken et al categorized this rare entity into three groups with distinct definitions (hypersinus, PD, and pneumocele) in 1987. The nomenclature and pathophysiology of this rare entity are a continuous controversy as the exact etiology and pathogenesis of the condition still remain unknown. Patients with this condition may be asymptomatic or they can present with cosmetic deformity and nasal, eye, or neurological symptoms. A significant percentage of patients with this condition may have an associated lesion, especially intracranial pathology. Radiological investigations with computed tomography scan and magnetic resonance imaging are crucial to confirm the diagnosis and assess the extent of the disease or any associated lesions. PD can be treated conservatively or surgically, depending on the clinical presentation of the disease. A thorough clinical evaluation is needed to plan for the treatment.

Key words

pneumosinus dilatans - pneumocele - hypersinus

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