Mucocele of the sphenoid sinus: A rare cause of reversible 3(rd) nerve palsy

Ophthalmoplegia due to 3(rd) nerve palsy is a common occurrence, and is usually a sign of diabetes mellitus or a serious intracranial disease. We report a rare case of pupil sparing 3(rd) nerve palsy caused by mucocele of the sphenoid sinus. The patient regained 3(rd) nerve functions after successful decompression of the mucocele. Early and correct diagnosis of this relatively benign condition is important to prevent permanent neurological deficits, including visual loss by optic nerve atrophy. Etiology, clinical manifestations and treatment of the sphenoid mucoceles is discussed and available literature is reviewed.