Concurrent Mucocele and Silent Sinus Syndrome after Orbital Fracture Repair

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A 59-year-old man sustained a left medial wall-floor fracture requiring repair (Fig A). Eight years later, the patient presented with left-sided proptosis and binocular diplopia. Visual acuity was normal with no afferent pupillary defect. Extraocular movements were limited in supraduction and abduction in the left eye. Orbital computed tomography demonstrated a large soft tissue density representing a mucocele encasing the implant (Fig B). There was also opacification of the left maxillary sinus and bowing of the orbital floor consistent with silent sinus syndrome.