Left eye blindness after maxillofacial trauma

Ho Chi Minh City Four months after the maxillofacial trauma accident, Mr. Thai's eyes gradually became blurred and then he lost his sight. Examination discovered a tumor compressing his eye socket, causing blindness.

Mr. Ho Van Thai (63 years old, Long An ) said that he had a maxillofacial injury and was treated at a local hospital. Recently, his left eye gradually became blurred and then lost his sight. He visited Tam Anh General Hospital at the end of April. His left eye's vision was bright and dark, and his right eye's vision was 6/10. The doctor suspected that his vision was lost due to compression of the optic nerve. The results of a CT scan and MRI of the sinuses showed that the mucocele in the sinuses spread to the top of the eye socket, compressing the optic nerve, causing blindness.

Master, Doctor, CKII Tran Thi Thuy Hang (Head of the Department of Otorhinolaryngology, Tam Anh General Hospital, Ho Chi Minh City) said that to save vision, the only way is to surgically remove the mucocele and decompress the top of the eye socket. However, the prognosis for complete recovery of vision is very difficult because the patient came to the hospital too late.

Doctor Thuy Hang (second from left) and the surgical team removed the myxoma and restored the patient's optic nerve. Photo: Tam Anh General Hospital — Doctor Thuy Hang (second from left) and the surgical team removed the myxoma and restored the patient's optic nerve. Photo: *Tam Anh General Hospital*

The surgeon cut the mucocele through the nasal endoscope. When the tumor capsule was opened, cloudy mucus flowed out, the tumor was cut as wide as possible and neatly to avoid the risk of recurrence. The patient was stable and discharged after 3 days of treatment.

"After surgery on my left eye, I can see objects around me, although not clearly. I'm very happy, I hope I can see better in a while," Mr. Thai shared.

After surgery for mucocele, patients need to follow the doctor's care instructions. Patients need to eat a nutritious diet; limit exposure to dusty environments, fans, wind, air conditioning; do not smoke... so that the surgical wound heals quickly. Maintaining regular check-ups helps prevent the risk of tumor recurrence.

Sinus mucocele is a bulging mass in the sinus cavity that grows slowly. Patients often have symptoms when the tumor compresses adjacent organs such as the eye socket and skull base. Most cases present with eye symptoms such as edema, progressive loss of vision or blindness. Therefore, patients often think the problem is in the eyes without knowing the root cause is due to abnormalities in the nasal sinus area. Maxillofacial trauma is at risk of forming sinus mucocele.

Dr. Hang added that examination and treatment by the wrong specialist will not completely resolve the disease. Mistaken symptoms also make patients subjective, losing the opportunity for early treatment, full vision recovery, and even permanent blindness. Myxoma compressing and causing inflammation of intracranial tissues also leads to dangerous complications that can be life-threatening such as meningitis, brain abscess, etc.

When there are unusual symptoms in the ear, nose, throat, eyes or head and neck area that last for more than a week without improvement, the patient should see a specialist for timely treatment.

Nguyen Phuong

* Patient's name has been changed.

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