One-Year Follow-Up of a Frontal Sinus Mucocele Presenting with Ptosis
Abstract
A mucocele is a benign mucus-filled cyst that forms after obstruction of paranasal sinus drainage. Enlargement can erode adjacent bone, producing mass effect symptoms such as congestion, headache, and proptosis. Rarely, orbital extension can lead to ptosis from compression of Cranial Nerve III (the oculomotor nerve). This report presents a one-year clinical and imaging follow-up in a 79-year-old male after surgical management of a frontal sinus mucocele presenting with ptosis. Initial examination demonstrated right-sided eyelid ptosis with mild restriction on right upward gaze. Prior MRI and CT displayed a right frontal sinus mucocele with sinus expansion encroaching on the right superior orbit and extending into the orbit. Additional findings included multifocal bony thinning around the frontal sinus and inferior displacement of the right globe with proptosis secondary to mucocele extension. The patient was referred to ENT and underwent image-guided functional endoscopic sinus surgery (FESS) of the right frontal recess and associated sinuses, including maxillary antrostomy, posterior to anterior ethmoidectomy, and entry into the frontal sinus for drainage of mucopurulent material. Post-operative CT revealed an interval left medial antrectomy with a visible frontoethmoidal recess expansion. The right frontal sinus remained expanded and opacified, consistent with mucocele, with erosion of the superior orbital roof and persistent communication between the frontal sinus and orbit, causing mild inferior globe displacement. Additional findings included new opacification of the left frontal and bilateral maxillary sinuses and worsening sphenoid sinus disease, consistent with acute on chronic sinusitis. Follow-up examination at the ophthalmology clinic showed resolution of ptosis and diplopia, indicating successful FESS. This case highlights the uncommon clinical course of a frontal sinus mucocele resulting in orbital involvement and secondary complications, with ophthalmic symptom resolution after ENT surgical intervention.
Start Time
15-4-2026 1:30 PM
End Time
15-4-2026 4:30 PM
Room Number
Culp Ballroom 316
Poster Number
33
Presentation Type
Poster
Presentation Subtype
Posters - Competitive
Presentation Category
Health
Student Type
Graduate and Professional Degree Students, Residents, Fellows
Faculty Mentor
Brent Aebi
One-Year Follow-Up of a Frontal Sinus Mucocele Presenting with Ptosis
Culp Ballroom 316
A mucocele is a benign mucus-filled cyst that forms after obstruction of paranasal sinus drainage. Enlargement can erode adjacent bone, producing mass effect symptoms such as congestion, headache, and proptosis. Rarely, orbital extension can lead to ptosis from compression of Cranial Nerve III (the oculomotor nerve). This report presents a one-year clinical and imaging follow-up in a 79-year-old male after surgical management of a frontal sinus mucocele presenting with ptosis. Initial examination demonstrated right-sided eyelid ptosis with mild restriction on right upward gaze. Prior MRI and CT displayed a right frontal sinus mucocele with sinus expansion encroaching on the right superior orbit and extending into the orbit. Additional findings included multifocal bony thinning around the frontal sinus and inferior displacement of the right globe with proptosis secondary to mucocele extension. The patient was referred to ENT and underwent image-guided functional endoscopic sinus surgery (FESS) of the right frontal recess and associated sinuses, including maxillary antrostomy, posterior to anterior ethmoidectomy, and entry into the frontal sinus for drainage of mucopurulent material. Post-operative CT revealed an interval left medial antrectomy with a visible frontoethmoidal recess expansion. The right frontal sinus remained expanded and opacified, consistent with mucocele, with erosion of the superior orbital roof and persistent communication between the frontal sinus and orbit, causing mild inferior globe displacement. Additional findings included new opacification of the left frontal and bilateral maxillary sinuses and worsening sphenoid sinus disease, consistent with acute on chronic sinusitis. Follow-up examination at the ophthalmology clinic showed resolution of ptosis and diplopia, indicating successful FESS. This case highlights the uncommon clinical course of a frontal sinus mucocele resulting in orbital involvement and secondary complications, with ophthalmic symptom resolution after ENT surgical intervention.
