Presentation
Left side eye hypotropia, proptosis, and pain with a history of paranasal sinuses polyposis, and pansinusitis.
Patient Data
There are remarkable mucosal thickening and fluid in all paranasal sinuses with total sinus cavities and ostiomeatal complexes obliteration and large fluid containing expansile mass-like lesion in left frontal sinus extended within left orbital cavity upper segment through a large bone defect within orbital roof and floor of left frontal sinus with impression on related extraocular muscles and left eye uveo-scleral layer and caused left eye proptosis and hypotropia.
Case Discussion
The case is a 20-year-old male presenting with a runny nose, nasal speech, left eye proptosis, and pain. The non-contrast orbital and paranasal sinuses MDCT requested and large fluid containing expansile lesion in left frontal sinus compatible with frontal mucocele extended through a large bone defect in the left orbital roof within the orbital cavity with impression on left eye led to proptosis and hypotropia detected. Remarkable sinusitis in all paranasal sinuses with obliteration of nasal cavities and ostiomeatal complex also were seen. Chronic sinusitis is one of the major leading causes of the mucocele of paranasal sinus which could be more complicated by related eye proptosis.
The MDCT is the modality of choice for evaluation of the bony wall of the sinuses and the MRI is the best for mucocele-content characterization and differentiation from neoplastic lesions.
The treatment of the frontal mucocele is surgical and the functional endoscopic sinus surgery has better outcome and morbidity but the external surgical approach can be also considered based on the clinical condition of the patient.
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