Orbital mucocele

Description: An orbital mucocele can occur when sinus mucoceles cannot naturally drain through the nose. Instead, they grow and slowly invade adjacent tissues. Generally arising from the ethmoid or frontal sinuses, orbital mucoceles are mucus or fluid filled cysts which can displace the eye. 

(Description from the Eye Cancer Network)

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As a cystic fibrosis patient, Henrik has had lots of problems with sinus infections.

A general explanation of what CF does is that it makes all the mucous your body produces extra thick and sticky. So the primary symptom is that CFers cough a lot, because the mucous in the lungs, which usually comes up when you just clear your throat, sticks. Up until the 80s, part of the main treatment for CF was to pound hard on the patient’s back for like a half hour daily, to break up the mucous in the lungs so they could cough it up. It was never very effective, but it was all they had. Today they have drugs that break up the mucous much more efficiently than the pounding ever did. Interestingly, the drug (Mucomyst in both Swedish and English) is also an antidote for Tylenol/paracetamol poisoning.

Another typical problem for CFers is sinus blockage. It's actually the same thing -- the sinuses produce mucous and it's too thick to run out the way it's supposed to.  Eventually the mucous builds a cyst in the sinus, which presses down on the eye.

Usually people start getting double vision when the cyst starts pressing on the eye, and that’s how it’s discovered. Henrik is blind in one eye, so he didn’t get double vision.  What happened instead was that the cyst pressed the eye down and out significantly before anything was done about it.

By November 2003, there was a noticeable difference between the two eyes.

The operation went completely as planned.  It involved making an incision from the side of the nose and upwards into the swelling.  They drained some of the cyst, but left it partially inflated so they could make sure they scraped out all parts of it.

To make sure that the sinus passage doesn’t close over during the healing process, the ENT surgeon inserted a plastic tube, which would remain in place for two months.  It sticks out a little bit and looks rather strange. 

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The recovery process went very smoothly.  By the time he came home on day 4, Henrik felt fine—except that the tube was a bit of an annoyance.  Apparently it sits exactly in the way of the air flow (think about when your nose stings when you breathe in cold air—it’s always on the septum side of the nostril, not the outer edge.  That’s where the tube is).

So Mr. Inventor decided to do something about it.  He made his own little gizmo out of a paperclip that keeps the tube away from the side of his nostril, which both lets him breathe more freely and keeps the tube from chafing.  We thought of getting it patented, but the market for it surely isn’t very big!

April 13, 2004

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