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Endoscopic resection of a huge orbital ethmoidal mucocele masquerading as dacryocystocele
  1. Eugene Wong1,
  2. Nicholas Leith2,
  3. Geoff Wilcsek3,
  4. Raymond Sacks2,4
  1. 1Otolaryngology, University of Sydney Westmead Clinical School, Sydney, New South Wales, Australia
  2. 2Otolaryngology, Concord Repatriation General Hospital, Concord, New South Wales, Australia
  3. 3Ophthalmology, UNSW Prince of Wales Clinical School, Randwick, New South Wales, Australia
  4. 4Otolaryngology, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
  1. Correspondence to Dr Eugene Wong, eugene.hl.wong{at}


Paranasal mucoceles are cystic masses lined with epithelium thought to result from chronic obstruction of an impaired sinus ostia. If sufficiency large, they can cause ophthalmological sequelae including diplopia, visual acuity, globe displacement as well as the rhinological symptoms of facial pain and headache. We present the case of a 57-year-old man who presented with a 1-year history of epiphora and right globe prominence with associated diplopia. Imaging demonstrated a mass located within the medial aspect of the orbit, closely associated to the lamina papyracea and nasolacrimal duct consistent with a dacryocystocele. An alternate diagnosis of an ethmoidal mucocele was considered preoperatively following rhinologist opinion. Complete endoscopic resection of the cyst was undertaken. Histopathology confirmed diagnosis of an ethmoidal mucocele. Our report highlights mucocele should be considered in patients with chronic symptoms secondary to a mass situated in the nasolacrimal duct without radiological orbital bone destruction.

  • ear, nose and throat/otolaryngology
  • nasal polyps

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  • Contributors All authors (EW, NL, GW, RS) contributed to conception and design, drafting the article and critical revision and final approval of the manuscript. All authors agree to be accountable for the article and ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.