An unusual Case of Bilateral Ethmoidal Mucopyocele

Mucocele is defined as an epithelial-lined, mucus-containing benign sac completely filling the sinus and can be seen expanding to induce pressure effects on surrounding structures. Frontoethmoidal mucocele is by far the most common due to the complexity of its drainage, and incidence of maxillary mucocele is least. A 20-year-old female presented with a chief complaint of protruding right eyeball, redness and watering from both eyes, persistent headache, and decreased vision in both eyes since 4 months, along with complaint of diplopia and bilateral nasal obstruction with marked nonaxial proptosis, chemosis, and downward globe displacement along with telecanthus and lateral dystopia in the right eye. Orbital movements were restricted in superolateral direction. Vision was markedly decreased. Fundus examination was normal on the left side, but right eye showed hyperemic optic disk and full optic cup with dilated blood vessels. Right corneal examination showed signs of exposure keratitis. Contrast-enhanced computed tomography (CECT) of the paranasal sinus (PNS) revealed bilateral mucocele in ethmoid sinus with hypoplastic frontal and maxillary sinus with aplastic sphenoid sinuses, which is not a common presentation. Endoscopic-wide marsupialization of bilateral mucopyocele was performed under general anesthesia.