Endoscopic sinus surgery for paranasal sinus mucocoele with orbital involvement

Khong, Jwu Jin; Malhotra, Raman; Wormald, Peter John; Selva, Dinesh

doi:10.1038/sj.eye.6701347

Cited by 47 publications

(56 citation statements)

References 12 publications

(19 reference statements)

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“…Treatment is surgical with excision/resection [6]. This is increasingly undertaken via a transnasal endoscopic route and a recent retrospective series of paranasal sinus mucocoeles with radiologic orbital extension has shown surgery to be successful in resolving ophthalmic signs and symptoms [7]. Review of the available individual cases and case series in the English-language literature confirms a good prognosis, with diplopia and ocular signs disappearing rapidly after surgery with infra-orbital numbness taking longer to normalize [4].…”

Section: Discussionmentioning

confidence: 89%

Diplopia due to maxillary sinus mucocoele

Sheth

Goel

2007

Int Ophthalmol

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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.

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Section: Discussionmentioning

confidence: 89%

Diplopia due to maxillary sinus mucocoele

Sheth

Goel

2007

Int Ophthalmol

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“…The obliteration of the frontal sinus with abdominal fat is recommended when mucoceles are not accessible endoscopically [21]. A number of publications advocate endoscopic sinus surgery, including the endoscopic-modified Lothrop procedure (also known as Draf III or frontal drillout) as a safe and effective approach for complex and simple paranasal mucocele management [19,20,22]. Apart from the common causes of orbital complications it is important to consider rare aetiologies.…”

Section: Discussionmentioning

confidence: 99%

Orbital complications:diagnosis of different rhinological causes

Matsuba

Straßen

Hofauer

et al. 2014

Eur Arch Otorhinolaryngol

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To evaluate the clinical course of orbital complication using a standardised diagnostic pathway. Seventy-three patients with orbital complications underwent a multimodal diagnostic pathway comprising ENT examination, leucocytes/CRP, CT-/MRI-scanning and disease-related data. Twenty-nine patients suffered from rhinosinusitis, 28 from mucoceles, 13 patients from neoplasms and three patients from rheumatic disorders. Clinical examination diagnosed 60 patients with eyelid swelling, 55 patients with ocular pain, 14 patients with diplopia, 4 patients with exophthalmus, 29 patients with visual field defect and 4 patients with visual loss. The diagnostic pathway identified acute rhinosinusitis with a sensitivity/specificity of 90 %/90 %, mucoceles with 79 %/100 %, neoplasms with 100 %/96 % and granulomatosis with polyangiitis with 100 %/100 %, respectively. All patients left the hospital in good general condition and with regular ocular motility; two patients suffered persistent visual loss. The standardised application of a widely accepted diagnostic pathway reliably distinguishes different causes of orbital complication.

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“…Khong et al stated that 93% of the patients had had former sinus surgery and 80% of the patients had chronic sinusitis in their study. 7 In the literature, postoperative maxillary sinus mucocele development has been reported even after 10-19 years the operation. [7][8][9] Our patient stated that she underwent endoscopic sinus surgery 22 years before.…”

Section: Discussionmentioning

confidence: 99%

“…7 In the literature, postoperative maxillary sinus mucocele development has been reported even after 10-19 years the operation. [7][8][9] Our patient stated that she underwent endoscopic sinus surgery 22 years before. The diagnosis of mucocele is based on symptoms, imaging, surgical exploration and histological confirmation.…”

Section: Discussionmentioning

confidence: 99%