A new approach to aesthetic maxillofacial surgery: surgical treatment of unilateral exophthalmos due to maxillary sinus mucocele.

Unilateral exophthalmos has often been a difficult and exciting subject for surgeons [1]. Its most frequent cause appears to be the mucocele from paranasal sinuses. Mucocele constitutes 7% of all orbital tumors and 2.7% of non-endocrine exophthalmos cases [2]. Its etiology involves blockage of a sinus cell ostium. The blockage may occur spontaneously without sinus abnormality or as a result of trauma, postsurgical injury, tumor growth, chronic inflammation, or infection. The maxillary sinus mucocele can advance and generate exophtalmia, with diplopia and genian swelling. These modifications are caused by the destruction of the maxillary and malar bone. In these circumstances, the unilateral exophthalmos is difficult to treat in order to restore both eye function, a normal facial aspect, and normal temporomandibular masticatory function, ensuring a quality of life as high as possible [3].