Bedeutung der 10-MHz-Sonographie zur Diagnostik und Verlaufskontrolle der retrobulbären Mukozele

Abstract

Immediately after a flight from Europe to the USA a 45-year old German woman noticed an unilateral protrusion of the eye with retrobulbar pressure, diplopia and blurred vision. Except for a nasal polypectomy 23 years ago the past medical history was unremarkable. The above mentioned symptoms disappeared spontaneously but reoccurred after a second flight to Turkey six months later. The ultrasound examination of the orbital cavity showed a large suprabulbar mucocele which displaced the eyeball downwards. An intracerebral expansion was excluded by NMR-tomography. The mucocele was removed surgically but reappeared when the patient had a cold. All symptoms disappeared within 2 weeks of taking antibiotics. Fluctuation of the air pressure in the aeroplane and below atmosphere pressure let the air in the sinuses expand. Via a connection between the nasal sinuses and the mucocele, the mucus is forcibly pressed into the mucocele, and the internal pressure rises. The clinical symptoms will therefore increase suddenly during a flight. The ultrasound examination is a reliable method for the differential diagnosis of retrobulbar tumor and should be used for follow-up examinations because of the simplicity and safety of the method.