The patient came 21-January-2012 complaining of episodes of paroxysmal tachycardia with feeling chest pain and discomfort with numbness of the upper and lower limbs starting and terminating abruptly for seconds for 8 months. The patient was seen by cardiologist and coronary CT-scan done was normal. He has headache with right ophthalmalgia for 6 months. EEG done 13-October-2011 confirming the presence of complex partial epileptic activity. MRI of the brain done 21-January-2012 showing huge retention cyst right half of the sphenoid sinus reaching the boundaries of the mediobasal right temporal lobe. The patient claim, that he had episode of inflammatory process of the right orbit for several days 1 month ago.

On examination, the patient is neurologically free. Tegretol 200 CR twice a day was started.

Using C-arm, the nasal specula was inserted to the right nostril down to the anterior wall of the sphenoid sinus. Drilling of the wall was carried out to obtain 10x10 mm bone defect. Using endoscopic facility, the wall of the retention cyst was removed in one big piece and sent for histological studies. Using 0 and 30 degrees angle endoscope, the cavity was studied to rule out remnants and the hypervascularized bone at the mediobasl right temporal area region.

The mucosa around the bone defect was coagulated to prevent future closure and a sponge was inserted to the right nostril.

The patient have inflammatory lesion irritating the mediobasal right temporal lobe, triggering the epi activity. The aim of surgery is to prevent further escalation of the process and prevent intradural complications.