A CASE REPORT OF RECURRENT FRONTAL MUCOCOELE

Abstract

Background: Paranasal sinus mucocele is the epithelium lined mucus filled sac causing enlargement of sinus wall. It can cause bone erosion and displacement of surrounding structures. Mucoceles usually occur due to infection, inflammation, trauma, previous surgeries, and tumours which can potentially obstruct the sinus ostium. Cranio facial trauma is the commonest cause for mucocele formation. Case report: A 50yr old male patient came with chief complaints of swelling on forehead since 1yr. The patient had history of road traffic accident 13yrs ago for which he underwent facio-maxillary reconstruction along with right eye evisceration. Later he developed a swelling above right eye after 7yrs, which was diagnosed as mucocele and was treated by frontal cranioplasty. Now he came with complaint of swelling on forehead which was gradually increasing in size. MRI-PNS was done showing fluid filled space extending anteriorly from cutaneous plane in the frontal region going posteriorly over the orbit pushing the contents of the orbit inferiorly and medially and extending posteriorly up to orbital apex. Patient underwent endoscopic mucocele drainage and DRAF 3. Right orbital exenteration was done to prevent recurrence. Patient was on follow up since then and no symptoms or signs of recurrence is noted. Conclusion: Facial trauma may be one of the reasons for development of mucocele where sinus drainage pathways are deranged. As in our case trauma not only led to development of mucocele, but new spaces also created by the treatment lead to extensive spread of the mucocele.