88-year-old woman blinded by giant frontal sinus mucocele

Mucocele is a benign tumor in the nasal sinus area, mainly found in adults. This type of tumor can develop in one or more sinuses and is most commonly the frontal sinus mucocele. However, due to the nature of the tumor causing erosion and bone loss of the sinus wall leading to facial and eye socket deformities, it seriously affects the health and quality of life of the patient.

Recently, the Department of Ophthalmology - Vinh International Hospital received patient Dinh Thi V. (88 years old, residing in Duc Thuy commune, Duc Tho district, Ha Tinh province) with a condition of blindness. Taking medical history, it was found that 5 years ago, she had symptoms of double vision, blurred vision and a large tumor in the left eye area. Although she went to many places for examination and treatment, it did not improve. 2 years ago, Ms. V was diagnosed with cataract at the district hospital, and applied Phaco surgery but it did not improve.

Image of a 75x72x56mm tumor (arrow) on MRI results.

Through clinical examination, the doctor found a tumor in the left forehead area above the orbital margin.diameter about 4cm, soft, loose leading to pushing the eyeball down and out, drooping eyelid causing complete loss of vision in the left eye.

The Ophthalmologists and the Otorhinolaryngologists consulted and performed additional clinical tests to determine. The results of the nasal endoscopy showed a tumor in the left nasal cavity, with a smooth surface, clear boundaries, and growing to almost completely cover the left nasal cavity.

Combined MRI results show the image of the left frontal sinus mucocele growing into the ethmoid sinus and right frontal sinus, measuring 75x72x56mm. This is the cause of bone loss in the skull base, frontal sinus wall, eye socket wall, pushing the eyeball down and out.

Surgery is the best method to remove tumors and expand sinus drainage.

However, due to the patient's old age and weak condition, the large tumor causing many serious complications, there were many difficulties in choosing the surgical and anesthesia methods.

With the professional experience of the ENT specialist, working closely with the anesthesiologist and using an advanced endoscopy system, the surgery went smoothly.

Currently, the patient has recovered, the drooping eyelids are gone, the eyeballs have returned to their normal position, and the tumor on the forehead has completely subsided. Mrs. V. and her family are very satisfied with this result.

Patients before and after surgery. Photo: Kim Chung

Sinus mucocele is a rare disease, moreover, a tumor with a large size like the case of Mrs. V. is even less common in clinical practice. Although it is a benign tumor, it develops silently, but when it grows large, it will compress and destroy the bone of the sinus wall, deforming the face and eyes.

The cause of the disease may be due to:Nasal-sinus obstruction due to inflammation; Sinus trauma; Sinusitis that is not treated properly and is prolonged.

Common symptoms (when the tumor causes compression):Headache, stuffy nose, runny nose, swollen eye sockets, which can later cause facial and eye deformities.

Sinus mucocele will be treated by:X-ray, sinus endoscopy, magnetic resonance imaging (MRI).

Treatment of sinus mucocele:Surgery is the method of choice. Endoscopic sinus surgery, removal of the mucocele with its capsule, widening the nasal-sinus drainage opening.

Therefore, to detect abnormalities early, when having the above symptoms, patients should immediately go to a reputable medical facility to be examined and consulted with appropriate specialists for the most optimal treatment./.