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Optic neuritis and paranasal sinus diseases

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Čelakovský P., Vokurka J., Školoudík L., Růžička J.
Open Medicine
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2011
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vol. 6
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issue 1
117-119
EN
The relationship of sinusitis and paranasal sinus mucoceles to optic neuritis (ON) remains a challenge for both the otolaryngologist and the ophthalmologist. Currently, ON is assumed to be a rare complication of paranasal sinus diseases. Three new cases of ON associated with paranasal sinus diseases are described. We postulate different pathophysiologic mechanisms of ON in our three patients: compression of optic nerve due to sphenoid mucocele in the first patient; extension of bacterial infection to the optic nerve in the second patient; and invasion of aspergillosis to the orbital apex in the third patient. We assume that the complete recovery of the patient’s vision in the second case resulted from surgery, which had been performed immediately. A timely operation could possibly have prevented permanent blindness in cases 1 and 3 as well. Optic neuritis can occasionally be a complication of bacterial and mycotic sinusitis or paranasal sinus mucoceles, especially if located in the sphenoid sinus and posterior ethmoids. The evaluation of paranasal sinuses using imaging techniques is necessary to diagnose the problem, and immediate surgery can prevent permanent sequelae in indicated cases.
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Rare case of a massive buccal mucocele

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Koszowski R., Waśkowska J., Morawiec T., Wojcik S., Stęplewska K.
Open Medicine
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2011
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vol. 6
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issue 3
305-308
EN
Mucoceles are common pathological lesions of the oral cavity, usually measuring up to 10 mm. The authors describe a case of deeply located buccal mucocele measuring 35 mm in diameter. The lesion was caused by facial injury in a 54-year old man. The lesion persisted for approximately 2.5 years and was difficult to diagnose because of its unusual size and atypical clinical symptoms. Preoperative ultrasonography excluded a tumor, and this was confirmed by histopathological examination. However, oncological alertness was considered necessary on account of ulcerated mucosa next to the lesion. The mucocele was removed through surgical excision, using a scalpel and tissue scissors. No recurrence was observed in 2.5 postoperative years. It is stressed that histopathological examinations help to differentiate mucoceles from other disease processes.
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