Pan Pneumosinus Dilatans Presenting with Chronic Headache in a Young African Patient

Abstract

Background: The facial bones are normally aerated in adulthood, thus reducing the weight of the skull bones. Pneumosinus dilatans (PSD) is a rare condition of unknown aetiology in which there is over aeration and enlargement of one or more paranasal sinuses. PSD may be primary or secondary

Case description: A 16-year-old male presented with recurrent headaches of 4 years’ duration. There was no history or examination findings to suggest recurrent sinusitis. Computed tomography revealed enlargement of all paranasal sinuses without evidence of sinus obstruction. There was no facial asymmetry, and intracranial structures appeared normal. The patient was managed conservatively and is doing well.

A review of the literature highlights the importance of radiologic investigations in the evaluation of PSD, especially in defining the extent and diagnosing associated conditions.

Conclusion:  PSD is a benign condition which can be managed conservatively. Surgical intervention may be reserved symptomatic sinus obstruction or disfiguring changes.