Olaleye Oladejo, Salleh Shizalia, David Don, Bickerton Richard
Department of Otolaryngology,Warwick Hospital, Warwick, UK
Department of Otolaryngology,Warwick Hospital, Warwick, UK.
J Surg Case Rep. 2013 Feb 14;2013(2):rjt002. doi: 10.1093/jscr/rjt002.
This was an unusual case of lacrimal sac compression by an anterior ethmoidal mucocele presenting as a late complication of a dacryocystorhinostomy (DCR) that was jointly managed by ophthalmic and ENT surgeons via an endoscopic approach. A 22-year-old lady presented with a 12-month history of a painless lump in her left medial canthus area and a 6-month history of left intermittent epiphora. She had a DCR when she was 15 years old with initial symptom control until recent recurrence. There were no nasal or other eye symptoms. The rest of the eye and nasendoscopic examinations were unremarkable. An MRI scan suggested a dacryocystocele; however, a further CT scan revealed a 1.6 cm cystic lesion consistent with an anterior ethmoidal mucocele compressing the lacrimal sac. An endoscopic left anterior ethmoidectomy with marsupialisation of the mucocele was performed in combination with an endoscopic DCR. She made good post-operative recovery.
这是一例不寻常的病例，即筛窦黏液囊肿压迫泪囊，表现为泪囊鼻腔吻合术（DCR）的晚期并发症，由眼科和耳鼻喉科医生通过内镜方法联合处理。一名22岁女性，左侧内眦区出现无痛性肿块12个月，左侧间歇性溢泪6个月。她15岁时接受了DCR，最初症状得到控制，直到最近复发。无鼻部或其他眼部症状。眼部其他检查及鼻内镜检查均无异常。MRI扫描提示泪囊膨出；然而，进一步的CT扫描显示一个1.6 cm的囊性病变，符合筛窦黏液囊肿压迫泪囊。在内镜下行左侧前筛窦切除术并对黏液囊肿进行袋形缝合，同时行内镜下DCR。术后恢复良好。
