Mucoceles of the sphenoidal sinus: a report of four cases and review of the literature. Mucoceles of the sphenoidal sinus represent less than 2% of paranasal sinus mucoceles. The purpose of this paper is to report our experience in patients with mucoceles of the sphenoidal sinus. Four patients with this localization were observed in our department from 1994 to 2005. Symptoms included headache, visual loss, and rhinorrhea. All patients underwent computed tomography (CT) and magnetic resonance imaging (MRI). Surgery was performed using an endonasal endoscopic procedure, in one case a navigational system was used. In light of these observations and a review of literature, the etiopathogenic characteristics, clinical aspects, and therapeutic indications of this localization are discussed.