Report of Four Cases Demonstrating Severe Visual Disturbance due to Mucoceles of the Posterior Paranasal Sinuses

Abstract

We reported four cases demonstrating severe visual disturbance due to mucoceles of the posterior paranasal sinuses. Two of the four patients also complained of headache and blepharoptosis or retroorbital pain. All patients were referred to our out-patient clinic by a neurosurgeon or ophthalmologist. They underwent emergency drainage surgery. We found a bony defect of the optic nerve canal in all patients. Three patients reported remarkable improvement of visual acuity postoperatively, although the optic disc in one patient appeared pale preoperatively. The remaining patient did not recover visual acuity. In that case, the optic disc was preoperatively edematous and hyperemic, and become atrophic postoperatively. There was bacteria growth found on culture of the contents of mucoceles. All patients had consulted either a local physician or ophthalmologist within two days of symptom onset. However, patients were referred to us five to 11 days (average: five days) after they initially consulted their hospital. Early diagnosis and prompt surgical management are indispensable in the treatment of severe visual disturbance due to mucoceles of the posterior paranasal sinuses.