Primary cholesteatoma of the sphenoidal sinus-surgical treatment with video

Nasal sinus primary cholesteatomas are quite uncommon. Only five cases of sphenoid sinus cholesteatoma have been documented in the literature, with frontal sinus involvement being the most common. Our goal is to further scientific knowledge by describing the sixth case of primary cholesteatoma of the sphenoid sinus without extra-sinus extension and demonstrating the disease's surgical treatment in video. We discuss the case of a healthy women in her twenties who complained of a developing headache for years that worsened when combined with nasal symptoms. A bilateral sphenoidotomy was performed, with the whole cholesteatomatous matrix removed (partially preserved in areas with dehiscence). At 3 years, a sustained remission of the illness is noted. Progressively worsening headache may be a manifestation of sphenoid sinus pathology that may require surgical treatment. In this case, a rare disease such as sphenoidal cholesteatoma was noted. Surgical debridement must be carried out to avoid complications.