A CASE OF FRONTAL MUCOCELE COMPLICATED BY SUBCUTANEOUS ABSCESS OF THE UPPER EYELID THAT RUPTURED THROUGH THE OVERLYING SKIN

Abstract

　Recurrent infection of a frontal mucocele can lead to frontal osteomyelitis and subperiosteal abscess formation in the orbit, resulting in orbital complications. We report a case of frontal mucocele complicated by formation of a subcutaneous abscess in the upper eyelid that ruptured through the overlying skin. A 51-year-old man visited us complaining of right upper eyelid swelling and tenderness. On examination, we found a subcutaneous abscess of the upper eyelid that had ruptured through the overlying skin. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a right frontal mucocele and inflammation of the supraorbital margin. Therefore, we made the final diagnosis of frontal mucocele complicated by formation of a right upper eyelid abscess rupturing through the overlying skin. Endoscopic sinus surgery was performed to open the maxillary sinus and frontal mucocele into the nasal cavity. Then, we performed craniotomy, resected the frontal mucocele, and cranialized the frontal sinus by inserting a frontal musculoskeletal flap into the floor of the frontal sinus. The anterior skull base was covered with a pedicled septal mucosal flap. The upper wall of the right orbit was reconstructed by a bone graft taken from the skull. The postoperative course of the patient was satisfactory. At present, 6 months since the surgery, the patient can open his right eye normally. Upper eyelid lesions complicating a frontal mucocele should be managed by collaboration between the departments of otolaryngology and other relevant departments.