1
|
Nayak A, Sharma A, Ramachandran S, Vardhana KRH. Pediatric isolated intraorbital mucocele: Case report and review of literature. Oman J Ophthalmol 2024; 17:268-270. [PMID: 39132126 PMCID: PMC11309555 DOI: 10.4103/ojo.ojo_131_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 12/23/2023] [Accepted: 05/16/2024] [Indexed: 08/13/2024] Open
Abstract
A 9-year-old child presented with a palpable swelling under the right lower lid for 3 years. On examination, the swelling was nontender, well circumscribed, and cystic on palpation. A computed tomography scan showed a well circumscribed, hyperdense lesion in the inferior orbit with no anatomic connection with the paranasal sinuses. Transcutaneous orbitotomy was performed, and the lesion was excised in toto. Histopathological examination was suggestive of a mucocele.
Collapse
Affiliation(s)
- Arpita Nayak
- Department of Ophthalmology, Sri Sathya Sai Institute of Higher Medical Sciences, Prasanthigram, Andhra Pradesh, India
| | - Anuj Sharma
- Department of Ophthalmology, Sri Sathya Sai Institute of Higher Medical Sciences, Prasanthigram, Andhra Pradesh, India
| | - Sandhya Ramachandran
- Department of Pathology, Sri Sathya Sai Institute of Higher Medical Sciences, Prasanthigram, Andhra Pradesh, India
| | - K. R. Harsha Vardhana
- Department of Radiology, Sri Sathya Sai Institute of Higher Medical Sciences, Prasanthigram, Andhra Pradesh, India
| |
Collapse
|
2
|
Cancio LM, Chin M, Tumuluri K. Isolated Orbital Apex Mucocele: A Case Study and Literature Review. Ophthalmic Plast Reconstr Surg 2023; 39:e192-e194. [PMID: 37405766 DOI: 10.1097/iop.0000000000002443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
Isolated orbital mucocele without connection between the mass and paranasal sinuses is extremely rare and poorly understood. Literature review of these cases are very few and present more anteriorly in the orbit. Here, the authors present a 33-year-old female with an isolated left orbital apex mucocele without direct communication with the adjacent paranasal sinuses and other vital orbital structures. Endoscopic sinus surgery with marsupialization was performed, and an orbital mucocele was confirmed on histopathology. Although uncommon, previously reported cases, including our patient have remained disease free of recurrence for at least 1 year post-operatively.
Collapse
Affiliation(s)
- Lorenzo Maria Cancio
- Department of Oculoplastic Surgery, Sydney Eye Hospital, New South Wales, Australia
| | - Michael Chin
- The Departments of Otolaryngology and Ophthalmology, Liverpool Hospital, New South Wales, Australia
| | - Krishna Tumuluri
- Department of Oculoplastic Surgery, Sydney Eye Hospital, New South Wales, Australia
- The Departments of Otolaryngology and Ophthalmology, Liverpool Hospital, New South Wales, Australia
- Save Sight Institute, University of Sydney, New South Wales, Australia
| |
Collapse
|
3
|
Alouda N, Alkhiary H, Alsaleh S. Isolated extra-sinus subcutaneous mucocele: A case report. Int J Surg Case Rep 2023; 109:108488. [PMID: 37454551 PMCID: PMC10372322 DOI: 10.1016/j.ijscr.2023.108488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023] Open
Abstract
INTRODUCTION Paranasal sinus mucoceles are epithelialized cystic masses formed through the accumulation of sterile mucus. Mucoceles are expansile lesions, and their symptoms change according to their extension into the surrounding structures: anteriorly to the subcutaneous tissue, laterally to the orbit, or posteriorly to the cranium. Herein, we report the case of a pediatric patient with an isolated subcutaneous mucocele with no sinus connection. PRESENTATION OF CASE Physical examination revealed a non-tender fluctuating round mass approximately 4 cm in diameter in the right supraorbital region. Computed tomography and magnetic resonance imaging findings suggested a mucocele, and the diagnosis was confirmed via histopathological examinations postoperatively. The patient underwent a combined surgical approach that included an endoscopic transseptal approach to the frontal sinus with a right sub-brow incision and drain placement. The right frontal sinus was opened, and the mucocele was marsupialized. At the 3-month follow-up visit, the frontal sinus neo-ostium appeared patent on endoscopic examination, and the frontal sinuses were clear on imaging. DISCUSSION The optimal treatment for frontal mucoceles is marsupialization and adequate sinus drainage. As the patient had an isolated subcutaneous extra-sinus mucocele above the orbit, a combined approach was used to ensure thorough removal of the lesion to reduce the recurrence rate. CONCLUSION This report emphasizes the importance of using a combined approach for the removal of lesions and limiting the potential risk of recurrence in similar cases.
Collapse
Affiliation(s)
- Nada Alouda
- Department of Otolaryngology-Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hattan Alkhiary
- Department of Ophthalmology, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Saad Alsaleh
- Rhinology and Endoscopic Skull Base Surgery Unit, Department of Otolaryngology-Head & Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
| |
Collapse
|
4
|
Jungbauer F, Gvaramia D, Huber L, Kramer B, Ponto KA, Popovic Z, Riffel P, Rotter N, Scherl C, Zaubitzer L, Lammert A. [Differential diagnosis of intraorbital masses - a narrative review]. Laryngorhinootologie 2021; 101:390-398. [PMID: 34902864 DOI: 10.1055/a-1580-7371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Intraorbital masses represent a condition that is frequently threatening for the visual system. A rigorous differential diagnosis is essential to promptly initiate appropriate therapy and optimize prognosis. MATERIALS/METHODS Narrative review of current literature and expert recommendations. For further illustration we describe the case of a 71-year-old male admitted to our department three months after sinus surgery. Postoperative intraorbital hematoma of the right orbit had been treated conservatively with antibiotics/corticosteroids, leading to a near-complete unilateral visual loss. The immediate surgical intervention aimed at decompression of the orbit and the optical nerve. Due to the delay, the intervention could not prevent formation of a lipogranuloma. Inflammatory phases associated with the lipogranuloma are successfully managed by conservative treatment based on multidisciplinary recommendations. RESULTS In the case reported, delay of surgical therapy acted as a cause of intraorbital lipogranuloma formation. Literature supports our recommendation of immediate surgical intervention in case of acute retrobulbar hematoma. Besides acute conditions, intraorbital masses can be a sign of systemic disease. In every case, a multidisciplinary therapeutic approach is required for adequate management. CONCLUSIONS Intraorbital masses can occur as a complication of trauma or e.g. sinus surgery. On the other hand they can be a sign of systemic disease. Timely diagnosis and treatment prevents from visual loss. That is why rigorous differential diagnosis is essential for every discipline managing intraorbital lesions.
Collapse
Affiliation(s)
| | | | - Lena Huber
- HNO, Universitatsklinikum Mannheim, Mannheim, Germany
| | | | - Katharina A Ponto
- Universitäts-Augenklinik, Universitätsklinikum Mainz, Mainz, Germany
| | - Zoran Popovic
- Pathologisches Institut Mannheim, Universitätsklinikum Mannheim, Mannheim, Germany
| | - Philipp Riffel
- Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Mannheim, Mannheim, Germany
| | - Nicole Rotter
- HNO, Universitatsklinikum Mannheim, Mannheim, Germany
| | | | | | - Anne Lammert
- Fakultät Mannheim, ENT, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
5
|
Endoscopic Intranasal Marsupialization of the Isolated Mucocele in the Inferior Orbit. J Craniofac Surg 2021; 32:e545-e546. [PMID: 33534306 DOI: 10.1097/scs.0000000000007506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Isolated intraorbital mucocele without anatomical communication between the sinus and orbital cavity, and all orbital walls are intact is rare. It may lead to many orbital symptoms including proptosis, diplopia, orbital pain. Traditionally, many cases of typical paranasal sinus mucocele are successfully treated with endoscopic marsupialization. Most of the isolated intraorbital mucoceles were treated with complete removal of the mucocele via an external approach. However, there are many disadvantages of the external approach, and a case of isolated intraorbital mucocele in medial orbit treated by endoscopic intranasal marsupialization was reported. Here, the authors report a case of isolated orbital mucocele in inferior orbit treated by endoscopic intranasal marsupialization.
Collapse
|
6
|
Che Mat CMH, Mustapha F, Noor RM, Ramli R, Mohamad I. A Rare Intraorbital Mass: An Isolated Mucocele. Medeni Med J 2020; 35:344-348. [PMID: 33717628 PMCID: PMC7945724 DOI: 10.5222/mmj.2020.01057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 11/30/2020] [Indexed: 11/28/2022] Open
Abstract
Mucocele is a mucous filled benign cystic lesion. It develops due to obstruction of any natural os-tium of the paranasal sinus. Even though being benign, it has capability to erode and cause thinning the adjacent bony structures. Isolated intraorbital mucocele without paranasal sinus disease is a rare condition. We present a 39-year-old female patient with right medial canthal swelling without any nasal symptoms, and normal nasoendoscopic finding. Imaging revealed the lesion as a right ethmoidal mucocele with normal paranasal sinuses. However intraoperatively, it was an isolated intraorbital lesion, lateral to lamina papyracea with thick-yellowish mucin discharge.
Collapse
Affiliation(s)
- Che Mohd Hilmi Che Mat
- Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology-Head and Neck Surgery, Kelantan, Malaysia
| | - Fakri Mustapha
- Hospital Raja Perempuan Zainab 2, Department of Otorhinolaryngology-Head and Neck Surgery, Kelantan, Malaysia
| | - Rosli Mohd Noor
- Hospital Raja Perempuan Zainab 2, Department of Otorhinolaryngology-Head and Neck Surgery, Kelantan, Malaysia
| | - Rosdi Ramli
- Hospital Raja Perempuan Zainab 2, Department of Otorhinolaryngology-Head and Neck Surgery, Kelantan, Malaysia
| | - Irfan Mohamad
- Universiti Sains Malaysia, School of Medical Sciences, Department of Otorhinolaryngology-Head and Neck Surgery, Kelantan, Malaysia
| |
Collapse
|
7
|
Prendes MA, Perszyk I, Horkey D, Sokol J, Timoney P. Isolated orbital mucoceles in the absence of obstructive sinus disease. Orbit 2017; 36:388-391. [PMID: 28812911 DOI: 10.1080/01676830.2017.1337195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 05/28/2017] [Indexed: 06/07/2023]
Abstract
Orbital surgeons are quite familiar with the diagnosis and management of paranasal sinus mucoceles due their frequent involvement of the orbit. These benign masses form and expand following sinus outflow obstruction secondary to various causes including trauma, inflammation and malignancy, amongst others. The authors present two cases of isolated orbital mucoceles without associated sinus outflow obstruction. There were notably no connections between the paranasal sinuses and the lesions. The mucoceles were diagnosed following orbitotomies and excisional biopsies with confirmatory histopathology. These rare orbital lesions should be considered when evaluating cystic orbital lesions, and the orbital surgeon should be familiar with the proposed pathophysiology and treatment recommendations.
Collapse
Affiliation(s)
- M A Prendes
- a Ophthalmic Plastic and Reconstructive Surgery . University of Louisville Department of Ophthalmology and Visual Sciences , Louisville , Kentucky , USA
| | - I Perszyk
- b Department of Ophthalmology , University of Kentucky College of Medicine , Lexington , Kentucky , USA
| | - D Horkey
- c Department of Ophthalmology , University of Kansas School of Medicine , Prairie Village , Kansas , USA
| | - J Sokol
- c Department of Ophthalmology , University of Kansas School of Medicine , Prairie Village , Kansas , USA
| | - P Timoney
- b Department of Ophthalmology , University of Kentucky College of Medicine , Lexington , Kentucky , USA
| |
Collapse
|
8
|
Baysal E, Mumbuç S, Kanlkama M, Klç A, Çevik C. Intraorbital Isolated Mucocele. J Craniofac Surg 2011; 22:754-5. [DOI: 10.1097/scs.0b013e318208542e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|