Immediate recovery of vision after marsupialization of a posterior ethmoidal mucocele

Abstract

Objectives: Mucoceles are pseudocystic slow-growing processes that arise within the paranasal sinuses. Location in the posterior ethmoid is infrequent, accounting less than 20% of all paranasal mucoceles. Frequently, mucoceles are only diagnosed when symptoms arise due to the progressive compression of the surrounding structures, like the optic nerves or intracranial structures. This paper reports an unusual presentation of this pathology in which a complete visual recovery was achieved after surgey.

Methods: Chart review and clinical report of a 48 years old female patient, diagnosed with a left posterior ethmoidal sinus mucocele and unilateral loss of vision. Emergent functional endonasal surgery was performed at the Department of Otorhinolaryngology of Hospital S. João – University of Porto Medical School.

Results: Upon recovering from anaesthesia, the patient reported an immediate subjective improvement of vision on the affected eye. A postoperative ophthalmologic examination, at 24 hours after surgery, confirmed normal vision and normal visual fields.

Conclusions: Posterior ethmoidal mucoceles are rare lesions with unspecific symptoms, often related to visual disturbances. Early diagnosis is essential in order to allow prompt surgical management and preserve visual function.