Mucocele of the ethmoidal sinus

Case contributed by Fakhry Mahmoud Ebouda


Abnormal forward protrusion of the right eye.

Patient Data

Age: 40 years.
Gender: Male

An expanding cystic mass lesion is seen arising from the right anterior ethmoidal air cells, extending and overlying the right maxillary antrum with thinning out of the sinus outlines. It breaks through the right posterolateral and inferior orbital wall and elevates the orbital floor with consequent proptosis. Consequent displacement of the inferior rectus muscle up and posterior aspect of the optic nerve medially. The lesion extends up with the erosion of the floor of the anterior cranial fossa with intracranial extra-axial extension.

Sizable right sided ethmoidal mucocele expanding the right group of ethmoidal air cells. It extends into the nearby right maxillary sinus superiorly expanding, remodeling and eroding the base of the right side of the anterior cranial fossa yet no intra-axial cerebral abnormal enhancement posterolaterally. It extends into the right orbit with effect as described above with no abnormal enhancement or optic disc compressive effect. 

Post operative image of mucocele freed from its surrounding, an endoscopic medial maxillectomy, total ethmoidectomy, and frontal sinusotomy was performed. The walls of the lesion were subsequently peeled from their abutment to bone.       

Case Discussion

Operated case of mucocele of the right ethmoid sinus.

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