Giant Frontal Sinus Mucocele Presented with Globe Ptosis and Diplopia

Abstract

Mucocele of the frontal sinus is most commonly involved location among the paranasal sinus mucoceles. Frontal sinus mucoceles can erode surrounding structures, which may result in intraorbital or intracranial complications. Frontal sinus mucoceles have a slow, progressive, growing nature and therefore, the majority of frontal sinus mucoceles frequently present late in their development. The most common clinical presentations of frontal sinus mucoceles include frontal headache,and ophthalmic symptoms, such as proptosis, periorbital pain, and impairment of ocular mobility. It is rare to find ptosis and diplopia as the chief complaints. A 82-year-old female patient was referred to use because of right upper eyelid drop and double vision for about one month. Contrastenhanced magnetic resonance imaging (MRI) of the orbit showed a giant frontal mucocele with bony erosion and compression of the right orbit. Her ptosis and diplopia resolved immediately after functional endoscopic sinus surgery was performed. A transnasal endoscopic approach is currently the surgical method of choice for managing frontal sinus mucoceles. This case report demonstrates that when eye problems occurred in such cases, sinus disease should be on our diagnosis list. Proper and well timed treatment is able to prevent inevitable complications.