Наблюдение больной с одновременным нахождением в лобной пазухе остеомы и мукоцеле

Abstract

The article presents a clinical case of successful treatment of a patient with an osteoma and mucocele in her left frontal sinus, with the development of intraocular complications: diplopia, exophthalmos, ptosis of the upper eyelid, restriction of the movement of the eyeball. After a thorough examination of the patient, consultations with an ophthalmologist, neurologist and CT scan and diagnosis, the patient underwent a frontotomy under endotracheal anesthesia. During the opening of the frontal sinus, a U-shaped periosteal flap was preserved, which is used later for plastic surgery of a postoperative bone defect. Under video endoscopic control, the membrane and contents of the mucocele and osteoma were removed, and the frontal-nasal anastomosis was controlled and expanded. The bone defect in the anterior wall of the frontal sinus was removed by alloplasty with a simulated polytetrafluoroethylene (ecoflon) plate fixed with a U-shaped periosteum graft. As a result of the operation, almost all intraocular complications were successfully eliminated. Histological examination of the material removed from the sinus confirmed the presence of a compact osteoma and chronically inflamed mucosa. This clinical observation is of interest in the rarity of simultaneously finding an osteoma and a mucocele in the frontal sinus, and the possibility of mucocele formation due to obstruction of the fronto-nasal anastomosis with an osteoma. The possibility of one of the methods for alloplasty of a bone defect is presented.