PMC4427451_01
External photograph discloses a palpable prominence in the medial canthal area with surrounding erythema.
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Clinical examination disclosed erythema in the medial aspect of the orbit, lower lid greater than upper eyelid, a palpable prominence under the medial canthal tendon and in the region of the nasolacrimal sac, and telecanthus on the right (Figure 1).
Magnetic resonance imaging (MRI) of patient demonstrating large ethmoidal mucocele on the right.. Notes: (A) Coronal T1 MRI, (B) sagittal T1 MRI, (C) axial T1 MRI.
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The mass had high signal intensity on T1 and low signal on T2 weighted images, and there was ring-like enhancement (Figure 2A-C), most consistent with an ethmoidal mucocele.
Images during FESS.. Notes: (A) View of sinus mucocele during FESS, (B) marsupialization of mucocele during FESS.. Abbreviation: FESS, functional endoscopic sinus surgery.
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The patient underwent functional endoscopic sinus surgery at the University of Miami with marsupialization of the right ethmoidal mucocele (Figure 3A and B), which was later confirmed by culture to be infected with E. coli.