Scuba Diver Presenting with a Giant Sphenoid Sinus Mucocele

Isolated sphenoid sinus mucocele is an uncommon clinical entity. Expanding mucocele in the sphenoid sinus may affect vital structures such as the optic nerve, internal carotid artery, and other adjacent structures. Hence, barotrauma causing sphenoid sinus mucocele may result in serious neurological disorders including headache and vision disturbances. The patient urgently requires treatment of endoscopic marsupialization of the sphenoid sinus mucocele. Here, a 35-year-old male diver presented with acute headache and was diagnosed as sphenoid mucocele by computed tomography scan and magnetic resonance imaging. He was treated immediately with oral corticosteroids, nasal decongestants, and antibiotics. Then, he underwent endoscopic transnasal sphenoidotomy and marsupialization of the mucocele. A high index of suspicion is needed to get such a rare clinical entity like sphenoid mucocele when a diver presents with a headache and/or visual problem.