Pneumosinus dilatans, pneumocoele or air cyst? A case report and literature review

Abstract

AbstractBackground:Pathological paranasal sinus expansion secondary to air is uncommon. However, this condition may be symptomatic or cosmetically apparent, requiring surgical intervention. Various terms have been used to describe this condition, and nomenclature is controversial.Method:An 18-year-old man presented with right facial pain, and was subsequently found to have pneumosinus dilatans of the maxillary sinus. A search was conducted of the PubMed, Medline and Embase databases, using the key words ‘pneumosinus dilatans’, ‘pneumoc(o)ele’, ‘pneumatoc(o)ele’ and ‘maxillary sinus’. Articles were also hand-searched. Relevant articles published in English were reviewed.Results:The literature review identified 36 cases involving the maxillary sinus (including the present case), with 19 cases reported as pneumosinus dilatans, 12 as pneumocoeles, two as pneumatocoeles, two as pneumosinus dilatans multiplex and one as an air cyst. However, based on the strict classification described by Urken et al., the majority of these cases should be reclassified as pneumocoeles.Conclusion:Whilst the nomenclature of this pathology is confusing, distinctions of terminology do not alter the management. Hence, we support the use of the term ‘air cyst’, to incorporate all these lesions.