Diplopia due to maxillary sinus mucocoele

Abstract

Mucocoeles are cyst-like lesions of the paranasal sinuses, which may rarely erode through the bony orbit and so displace or compress orbital contents. Such patients may present to ophthalmologists and other health care professionals with diverse problems including facial pain and swelling, proptosis, double vision, ptosis, infra-orbital anaesthesia, epiphora and optic nerve dysfunction with reduced vision. We present an illustrated interventional case report of an 81-year-old gentleman with a 2-week history of swelling around the left lower eyelid and malar region associated with double vision both in the primary position and particularly downgaze. We discuss the aetiology, diagnosis and contemporary management of maxillary mucocoeles and also the Caldwell-Luc procedure. The article serves as a reminder that maxillary mucocoeles may slowly and covertly invade the orbit and should be considered in the differential diagnosis in patients presenting with proptosis, globe displacement and an orbital or adnexal mass.

Maxillary Sinus Mucocele with Exudative Retinal Detachment and Ocular Dystopia Without Diplopia

“…9 When the maxillary sinus mucocele cases published in the literature are reviewed, it is seen that ocular displacement is frequently accompanied by diplopia. [4][5][9][10][11] In the case of maxillary sinus mucocele with diplopia reported by Sheth et al, the patient had a swelling story in the malar region and around the lower eyelid for two weeks. 11 In the case of Raman et al, the first complaint of the patient was facial numbness and vaguely transient double vision, and he was followed by neurology with the diagnosis of trigeminal neuralgia for several months.…”

“…[4][5][9][10][11] In the case of maxillary sinus mucocele with diplopia reported by Sheth et al, the patient had a swelling story in the malar region and around the lower eyelid for two weeks. 11 In the case of Raman et al, the first complaint of the patient was facial numbness and vaguely transient double vision, and he was followed by neurology with the diagnosis of trigeminal neuralgia for several months. 5 In this second case, diplopia suddenly emerged with an increase in proptosis and a limitation in ocular movements.…”

Maxillary Sinus Mucocele as a Late Complication in Zygomatic-Orbital Complex Fracture

“…Surgical treatment is indicated especially when the mucocele compromises adjacent structures to avoid severe complications and permanent damage. The treatment of choice for this condition is surgical enucleation through an open surgical field, endoscopy or a combined approach 141516. Regarding the necessity of simultaneous lesion enucleation and orbital floor reconstruction with titanium mesh, an infraorbital incision and the Caldwell-Luc technique with total removal of the mucous membrane and inferior antrostomy were performed.…”