Pyocele of the posterior ethmoidal cell as the cause of visual loss
Matyja, G.; Kawczyński, M.; Tarnowska, Cława.
Otolaryngologia Polska 60(2): 171-174
2006
ISSN/ISBN: 0030-6657 PMID: 16903332 Document Number: 601690
Mucocele is a cystic slow-growing lesion of paranasal sinuses with sterile content. Pyocele contains purulent substance. Muco-/pyocele is rarely localised in ethmoid or sphenoid sinus and may involve the orbit and cause ophthalmic complications including visual loss. We report the case of a 25-year-old woman who suffered from sudden visual loss of her left eye. She was treated for optic nerve papillitis by neurologists and ophthalmologists with steroids and recovered after about 6 weeks. Magnetic resonance imaging was ordered to find the cause of visual disturbance and revealed an oval-shaped lesion in the left posterior ethmoid sinus. The patient underwent functional endoscopic surgery and transethmoidal marsupialisation of the muco-/pyocele. After endoscopic microsurgery the patient recovered without complications, she is under follow-up and has no symptoms of any disease. Because there were no evidence of any other causes of optic nerve affection, the muco-/pyocele was regarded as the cause of visual loss. The posterior ethmoid muco-/pyocele can present with ophthalmic manifestations including blindness. Endonasal operation and steroids administration are the treatment of choice in such cases.