Frontal sinus mucocoeles result from obstruction of the sinus ostium. They can present with orbital and neurological symptoms. We discuss the case of a 27 year-old gentleman who presented to the emergency department with periorbital swelling, diplopia and headaches. His CT scan revealed a large frontal sinus mucocoele encroaching the anterior cranial fossa. The patient required urgent endoscopic sinus drainage. Case A 27 year-old gentleman attended the emergency department complaining of headaches and diplopia. He had initially noticed right periorbital swelling 4-weeks prior to his presentation. This had been followed by a 3-week history of double-vision which he was aware of when looking straight ahead, and which seemed to be worse in the evenings. He had been suffering from right-sided headaches for 2-days. These came on in the mornings and lasted for an hour. He had experienced no vomiting or fits, but had a long history of nasal congestion and a postnasal drip.On examination the patient had pronounced right-sided proptosis. He had diplopia on upward and bilateral lateral gaze. Fundoscopy revealed right-sided optic disc oedema. The patient had an urgent CT scan. This showed a large right sided fontal sinus mucocoele. The posterior wall of the frontal sinus had expanded into the anterior cranial fossa, and due to the chronic pressure there had been significant deossification of the posterior wall of the sinus. There was also opacification of the left frontal sinus and the remaining paranasal sinuses (Image 1).
展开▼
