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Case Reports
. 2017 Dec;96(50):e9353.
doi: 10.1097/MD.0000000000009353.

An ethmoid mucocele causing diplopia: A case report

Jong Seung Kim  1 , Eun Ji Kim, Sam Hyun Kwon
Affiliations
Case Reports

An ethmoid mucocele causing diplopia: A case report

Jong Seung Kim et al. Medicine (Baltimore). 2017 Dec.

Abstract

Rationale: Mucocele is a disease lined primarily by epithelium, and occurs mainly when the sinus ostium is obstructed.

Patient concerns: We report a case of a 37-year-old man who presented with painless proptosis of the right eye and diplopia.

Diagnoses: The preoperative finding was mucocele of the ethmoid sinus.

Interventions: We performed endoscopic sinus surgery, which included uncapping of the anterior and superior wall of the mucocele.

Outcomes: The mucocele was treated safely and effectively without touching the medial orbital wall.

Lessons: Clinicians should note that minimally invasive surgery to remove ethmoid mucoceles is relatively straightforward and can prevent the various complications associated with these lesions.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1
(A) The patient had diplopia when looking left. (B) His limited extraocular muscle movement had improved after the operation.
Figure 2
Figure 2
A CT scan showed a 3.5 × 2.5 cm sized ovoid mass on the right ethmoid sinus. The lateral wall of the mucocele was eroded; however, the medial wall was calcified. CT = computed tomography.
Figure 3
Figure 3
Magnetic resonance imaging (MRI) scan showed a 3.5 × 2.5 × 3.4 cm sized oval-shaped mass on the right ethmoid sinus. MRI of the paranasal sinus demonstrated a hyperintense mass on T2-weighted images (A, coronal; B, axial) and intermediate signal intensity on T1-enhanced weighted images (C, coronal; D, axial). The mass was pushing the right medial orbital wall laterally, resulting in thinning of the right medial rectus muscle.
Figure 4
Figure 4
(A) The operation started with uncinectomy, and the whitish bony shell of the mucocele was seen. (B) After uncapping the anterior portion of the mucocele, yellowish thick mucus escaped from the mucocele cavity. We did not touch the epithelial lining of the medial orbital wall, which showed a Stankiewicz positive sign, which differed when the eye was (C) not pressed and (D) pressed.
See this image and copyright information in PMC

References

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