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Frontoethmoidal mucocele causing proptosis and visual loss.

Subhankar Dey1, Mehak Agarwal1

  • 1Department of ENT and Head and Neck, Apollo Gleneagles Hosipitals, Kolkata, West Bengal, India.

National Journal of Maxillofacial Surgery
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Summary

Frontoethmoidal mucoceles, benign sinus cysts, can cause vision loss and orbital complications. Endoscopic surgery offers effective treatment, though vision recovery is not always possible.

Keywords:
Mucusradiologysinus obliterationurgent interventions

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Ophthalmology

Background:

  • Mucoceles are benign cysts arising from sinus ostium obstruction, commonly affecting the frontal sinus.
  • These cysts can expand, leading to serious intraorbital and intracranial complications, including vision loss.

Observation:

  • A 54-year-old patient presented with acute vision loss and eyelid ptosis due to a frontoethmoidal mucocele.
  • Radiological imaging (CT and MRI) confirmed the mucocele breaching the left frontal sinus floor.

Findings:

  • Endoscopic orbital decompression and functional endoscopic sinus surgery were performed.
  • Post-operatively, eye movements and ptosis resolved, but vision loss persisted.

Implications:

  • Early diagnosis and intervention are crucial for managing mucoceles and preventing severe complications.
  • Endoscopic sinus surgery is the preferred approach for frontoethmoidal mucoceles, offering improved outcomes.
  • While surgical decompression can restore function, vision prognosis depends on the extent of optic nerve involvement.