Keywords: mycotic sphenoiditis, immunocompetent, visual loss

Abstract: The authors present an unusual presentation of a case of mycotic sphenoidal sinusitis in a 46 years old immunocompetent non-diabetic female. The initial symptom of sudden total visual loss on the left was not associated with proptosis, nasal or sinusal complaints. C.T. scan demonstrated narrowing of the optic nerve canal due to periosteal thickening, caused by an isolated left sphenoid sinusitis, suggestive of chronic fungal disease. Protrusion of the anterior wall of the left sphenoid sinus was observed on fiberoptic examination. Clinicai courses of antibiotics and steroids showed no visual improvement. Functional endoscopic sphenoidotomy was performed and a black mass was retrieved from the sinus. Histopathological specimem examination was suggestive of Aspergillosis. No surgical complication were observed; Ketoconazole and Predinisone were used post-operatively. Clinical, C. T. and endoscopic follow-up were performed and after two years no residual disease was noticed; visual improvement was close to 70%.