Pneumosinus dilatans as a cause of variable unilateral proptosis

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Abstract
Mucocoeles of the frontal sinus are relatively common and by pressure alone, over a period of time, may cause bone erosion and therefore a deficiency in the wall of the sinus. An anterior deficiency will result in a fluctuant swelling of the forehead while an orbital defect may cause proptosis. This [human] case is presented because of the widely varying degree of proptosis and to illustrate the mechanism involved. Where there is a bony deficit between the frontal sinus and the orbit, and provided air can still pass around a mucocoele, the orbit may be inflated by increased intranasal pressure (e.g., by nose-blowing or sneezing). This condition, described as pneumosinus dilatans, may cause alarming orbital symptoms. Obliteration of the sinus, after removal of the causative mucocoele, is curative.

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