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We describe an extremely rare case of a clival mucocele and complement the case report with a literature review. A 30-year-old woman presented to the emergency department with unclear neurologic symptoms after bouldering and left-sided hyposensitivity in her face and radial surface of the forearm. Magnetic resonance imaging was suspicious of a clival mucocele, which was confirmed in computed tomography. Endoscopic drainage of the mucocele was undertaken, after which the patient recovered fully., Competing Interests: Einhaltung ethischer Richtlinien. Interessenkonflikt: M. Santschi und M. Kyriakou geben an, dass kein Interessenkonflikt besteht. S. Negoias ist als Referentin für GSK und Sanofi tätig und ist zudem Advisory Board Member für Dupilumab bei Sanofi. Gemäß Rücksprache mit der Ethikkommission Nordwest- und Zentralschweiz (EKNZ) ist für diese Studie kein Votum der Ethikkommission notwendig, da die Patientendaten anonym gehalten werden. Für diesen Beitrag wurden von den Autor/-innen keine Studie an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien. Alle Patienten, die über Bildmaterial oder anderweitige Angaben innerhalb des Manuskripts zu identifizieren sind, haben hierzu ihre schriftliche Einwilligung gegeben., (© 2025. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.)

Background: Paranasal sinus mucoceles, by virtue of extension into the orbit or cranial vault, can lead to significant ocular, nasal, or neural complications. There is limited comprehensive data on the presentation, management, and outcomes of cases with intraorbital or intracranial extension. A thorough analysis is essential to enhance clinical practices and improve patient outcomes., Objective: This retrospective case series investigates the clinical presentations, radiological features, and surgical outcomes of 10 patients with paranasal sinus mucoceles exhibiting intraorbital or intracranial extensions., Methods: Ten diagnosed cases of paranasal sinus mucoceles with intraorbital or intracranial extensions, as identified on CT or MRI imaging, were selected and retrieved from the electronic database of an academic-affiliated hospital from July 2013 to December 2023. Data were analyzed using descriptive statistics with IBM SPSS version 23.0 software., Results: The study revealed a mean patient age of 65 years, with females (60%) affected more than males (40%). The ethmoidal and frontal sinuses were predominantly involved, with varied clinical symptoms ranging from periorbital pain to visual disturbances. Radiologically, CT and MRI scans depicted extensive sinus involvement, often with intraorbital (50%), intracranial (20%), or combined (30%) extensions. Surgical interventions, primarily endoscopic sinus surgery, resulted in favorable outcomes, including symptom resolution, minimal complications, and no recurrence., Conclusion: This case series emphasizes the importance of thorough preoperative evaluation, individualized surgical approaches, and vigilant postoperative care in managing mucoceles with orbital and cranial involvement. Further research with larger cohorts and extended follow-up periods is essential to refine treatment strategies and enhance patient outcomes for this complex pathology., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: To evaluate the results of a minimally invasive combined endoscopic and eyelid crease/medial suprabrow incision approach in collaboration with oculoplastic and sinus surgeons for the treatment of recurrent/recalcitrant sino-orbital mucoceles., Methods: Eighteen cases of recurrent/recalcitrant sino-orbital mucoceles, treated in collaboration with oculoplastic and sinus surgeons at the University of Michigan, were retrospectively reviewed. The recurrence of mucocele, reduction in proptosis, and complications were evaluated., Results: The mean age at the time of surgery was 49 years (range: 17-76 years). All cases had a history of previous sinus or orbital surgeries for mucoceles. Among 18 cases, eight were due to chronic sinus infections, six due to trauma, three due to Schneiderian papilloma, and one case was secondary to an inflammatory sinus disease. Thirteen cases (72%) presented with orbital or facial cellulitis, while five cases (38%) experienced periocular swelling and limited extraocular motility. Following a mean follow-up of 19 months (range: 1-76 months)), recurrence was observed in two cases (11%): one in a cystic fibrosis patient with chronic sinusitis, and the other in a case of Schneiderian papilloma. The mean pre-operative proptosis in the affected eye was 2.78 mm, with an average decrease of 2.33 mm after surgery. Complications occurred in two cases, including one case of hypoesthesia in the forehead and one case of post-operative strabismus., Conclusion: Our series of 18 cases of recurrent/recalcitrant mucoceles, with only two cases of recurrence, demonstrates that this minimally invasive approach can be successfully employed for advanced sino-orbital disease, with a low rate of adverse outcomes and aesthetically pleasing results.