A Case of Frontal Mococele Treated with Transblepharoplasty Approach Combined with Endoscopic Approach

Woong Jung Ji; Sung-Moon Hong; Jae-Min Shin; Soo-Hyung Lee; Heung-Man Lee

doi:10.18787/jr.2015.22.1.59

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Ji, Hong, Shin, Lee, and Lee: A Case of Frontal Mococele Treated with Transblepharoplasty Approach Combined with Endoscopic Approach

Case Report

J Rhinol 2015;22(1):59-62.

Published online: 10 January 2015

DOI: https://doi.org/10.18787/jr.2015.22.1.59

A Case of Frontal Mococele Treated with Transblepharoplasty Approach Combined with Endoscopic Approach

Woong Jung Ji, MD¹, Sung-Moon Hong, MD¹, Jae-Min Shin, MD¹, Soo-Hyung Lee, MD¹, Heung-Man Lee, MD, PhD^1,^2,^3,

¹ Department of Otorhinolaryngology-Head and Neck Surgery

² Biomedical Sciences

³ Institute for Medical Devices Clinical Trial Center, Korea University College of Medicine, Seoul, Korea

교신저자：이흥만, 152-703 서울 구로구 구로동로 148고려대학교 의과대학 이비인후-두경부외과학교실Tel: +82-2-2626-3185, Fax: +82-2-868-0475 E-mail: lhman@korea.ac.kr

Received 22 November 2012 Revised 8 April 2013 Accepted 25 January 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In recent years, endoscopic sinus marsupialization has become the treatment of choice for the treatment of paranasal sinus mucoceles due to its noninvasiveness and successful outcome. However, mucoceles located at the lateral portion of the frontal sinus and protruding into the orbit with erosion of the frontal sinus floor arestill difficult to address with standard endoscopic sinus surgery techniques. Here, we report a case of a mucocele located atthe lateral side of the frontal sinus and successfully marsupialized with a transblepharoplasty approach combined with an endoscopic approach.

Keywords: Mucocele, Frontal sinus, Nasal endoscopy, Blepharoplasty.

References

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Fig. 1.

Extraocular movements of the patient. Preoperative examination shows restriction with superior gaze (A). Postoperative examination shows recovered superior gaze (B).

Fig. 2.

Preoperative coronal CT scan of paranasal sinuses shows expansile heterogeneous soft tissue density at lateral portion of left frontal sinus with bony erosion of superior orbital rim (A). Preoerative T1-weighted Gadolinium enhanced coronal image reveals a heterogeneously expansile enhancing mass within in the left frontal sinus extending to the orbit (B).

Fig. 3.

Intraoperative findings. After anterior ethmoidectomy, frontal recess was widened under 70° endoscope and brown colored cystic mass was observed at lateral portion of left frontal sinus (A). Left upper lid incision was placed in a skin fold above the tarsal plate and myocutaneous flap was raised superficial to the orbital septum (arrow). The orbital periosteum was incised at the superior orbital rim and retracted inferiorly along with the orbital contents (C). The preexisting dehiscence of superior orbital rim was exposed and cystic wall of mucocele was removed (D).

Fig. 4.

Pathologic finding of the lesion shows chronic inflammation with foamy histiocytic infiltration (arrow) and fibrosis, which is consistent with mucocele (H&E, ×100).

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