耳鼻科ジャーナル

A Review of Orbital Involvement in Patients with Primary Paranasal Sinus Space Occupying Lesions in a South-East Asian Tertiary Centre

Shantha Amrith, Ko Ko Lin, JK Gangadhara Sundar and Chao Siew Shuen

A Review of Orbital Involvement in Patients with Primary Paranasal Sinus Space Occupying Lesions in a South-East Asian Tertiary Centre

Objective: To study the ophthalmic symptoms, signs and the outcomes after therapeutic intervention in patients with various space occupying lesions (SOL) of paranasal sinuses (PNS) in a tertiary referral centre in South-East Asia.

Patients and Methods: Retrospective review of all the cases with primary sinus SOL presenting with orbital involvement seen at the ophthalmic plastic service between January 1, 2000 and December 31, 2011.

Results: There were a total of 22 cases. Mean age was 51.5 years and male to female ratio was 2:1. Presenting ophthalmic signs were proptosis (77.3%), palpable mass (63.6%), ophthalmoplegia (54.6%), pain (36.4%) and poor vision (13.6%). All cases were co-managed by Eye and ENT surgeons, with 15 cases first detected by ophthalmologists and 7cases by otolaryngologists. Of the 22 cases, 10 (45.5%) cases were neoplasms, 9 (40.9%) were paranasal sinus mucoceles and 3 cases were dysplastic lesions. Mean follow up period was 23 months (3 months to 69 months).

Conclusion: PNS SOL cases can present with ophthalmic signs and symptoms to the ophthalmologists and often may be the first presentation. Diplopia and ophthalmoplegia are the most common ophthalmic disorders signifying orbital involvement by a PNS SOL. The outcome largely depends upon the primary etiology of the sinus lesion and efficacy of the multi-disciplinary approach.