Korean J Ophthalmol.  2012 Jun;26(3):212-215. 10.3341/kjo.2012.26.3.212.

Frontoethmoidal Mucocele Presenting as Progressive Enophthalmos

• Paik JS
• Kim SW
• Yang SW

• KMID: 1376128
• DOI: http://doi.org/10.3341/kjo.2012.26.3.212

Abstract

In this case report we describe a 27-year-old man who presented with progressive enophthalmos for 5 months without any other associated ocular symptoms such as pain, diplopia, or visual disturbance. Computed tomography showed that his progressive enophthalmos originated from a frontoethmoidal mucocele and this caused destruction of the lamina papyracea and shrinkage of the ethmoidal air cell. Finally the enlarged orbital space caused an inward deviation of the eyeball. Endoscopic marsupialization was successfully performed by an otolaryngologist and did not result in any ophthalmologic sequelae. Although frontoethmoidal sinus mucoceles mostly frequently originates from orbital mucoceles, enophthalmic manifestations are very rare. Enophthalmic conditions are not as responsive to surgical interventions as exophthalmic conditions.

Keyword

Enophthalmos; Sinus mucocele

MeSH Terms

Adult
Diagnosis, Differential
Endoscopy
Enophthalmos/diagnosis/*etiology/surgery
*Ethmoid Sinus
Follow-Up Studies
*Frontal Sinus
Humans
Male
Paranasal Sinus Diseases/*complications/diagnosis/surgery
Time Factors
Tomography, X-Ray Computed

Figure

• 

  Fig. 1 (A) Preoperative view of a 27-year-old man with right frontoethmoidal mucocele. Note the marked enophthalmos of right globe. (B) Preoerative computed tomography imaging: note the large right space occupying lesion from the frontal sinus extending toward ethmoid sinus. A destructive lesion of the lamina papyracea was found in the coronal view. (C) Preoperative magnetic resonance image imaging: the lesion showed T2 low signal intensity and T1 high signal intensity, which reflected the chronic state of frontoethmoidal mucocele.

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  Fig. 2 (A) Postoperative view after 8 months showed that 3.0 mm enophthalmos of the right globe still remained. (B) Postoperative computed tomography imaging at same time showed resolution of the bony pseudocapsule and reformation of the orbit, which resulted in the deviation of right medial wall toward the ethmoidal sinus.

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