전두동골절 수술 후에 발생한 점액낭종에 의한 안구돌출증

Exophthalmos caused by mucocele developed after surgery for frontal sinus fracture

Mucoceles arise from the gradual accumulation of mucus material caused by obstruction of the sinus ostium. They may enlarge sufficiently to compress orbital or intracranial structures. We present a case of severe exophthalmos caused by frontal sinus mucocele developed after operation for frontal sinus fracture. At initial operation for depressed fracture of the anterior wall of left frontal sinus, all frontal sinus mucosa was extirpated and the space was obliterated with bovine artificial bone. The fractured pieces of the bone were replaced and fixed with titanium mesh and screws. The reason for the delayed development of mucocele in this patient was the unintentionally remained sinus mucosa and blockage of the natural drainage pathway by bone graft. Exophthalmos was relieved after surgical drainage of mucocele, resection of mucosa as much as possible and recreation of drainage pathway by the removal of grafted bovine bone. This case reminds surgeons that natural drainage pathway of sinus should be kept intact whenever possible, otherwise a mucocele may develop even many years after operation.