Fifty-three patients (38 males and 15 females) with paranasal sinus cysts which were accompanied by orbital symptoms were treated in our hospital from May 1985 through May 1995. The average patient age was 48.3 years. Of 53 patients, 42 had undergone primary surgery for chronic sinusitis. The patients were classified into 4 groups according to the location of the cystic lesions, as follows: (1) maxillary, or maxillary-ethmoidal type: 15 cases. (2) frontal, or frontalfrontethmoidal type: 17 cases. (3) frontethmoidal type: 10 cases. (4) spheno-postethmoidal type: 11 cases. The common orbital symptoms were exophthalmos (19 cases), orbital pain (17 cases), periocular swelling (12 cases), lacrimation (12 cases), diplopia (11 cases) and visual disturbance (8 cases). The eight patients with visual disturbances were further analyzed.
In 6 out of the 8 patients, visual acuity returned to the expected level after surgery. The following conclusions were obtained from an analysis of the clinical features.
(1) Improvement of visual acuity was expected when the preoperative visual acuity remained measurable and surgery was performed within 3 months from the onset of visual disturbances.
(2) In case of severe visual disturbance postoperative prognosis was satisfactory when the light sense was still present and the optic disc had not atrophied.
