Paranasal sinus mucocele as a cause of unilateral amaurosis

Paranasal sinus mucoceles (PSM) are non-malignant epithelium-lined sacs arising from the paranasal sinuses containing inspissated mucus. The obstruction of a sinus ostium has been suggested as the primary etiologic factor, leading to expansion. Their formation might lead to a compressive mass lesion associated with inflammation. Malignancy is rarely found. Depending on their localization and expansion capacity, PSM can be responsible of severe medical conditions.

Case report A 58-year-old woman without previous relevant medical conditions was admitted at the emergency department with a loss of vision of acute onset affecting the left eye associated with a feeling of pressure behind the bulb. An initial ophthalmological assessment described the presence of a unilateral exophthalmus and confirmed the severity of visual impairment (visus left: 0,1; right 0,8). On examination of the nasal cavities, a big mucosal protrusion arising from the left sphenoidal and ethmoidal region could be observed. A CT scan showed a well-defined expansile mass arising from a left PSM with intraorbital affection. A subsequent MRI showed a contrast-enhancing mass affecting the left sphenoidal sinus with infiltrative bulging of the left lamina papyracea and intraorbital growth into the orbital apex, compressing the optic nerve, which showed incipient ischemic damage. The presumptive diagnosis of PSM was made, and the patient underwent surgery. After surgery, the patient experienced a fast recovery of her previous symptoms. Her visual aquity recovered fully.

Conclusion Here, we describe an uncommon complication of PSM associated with intraorbital growth into the orbital apex, leading to optic nerve compression and amaurosis.

Poster-PDF A-1587.pdf

Conflict of interest

Der Erstautor gibt keinen Interessenskonflikt an.

Publication History

Article published online:
13 May 2021