the family noticed the boy's left eye protruding unusually, though he did not experience nasal congestion, runny nose, or sinus pain. He had previously undergone eye and endocrine examinations, but the cause remained undetermined.

subsequently, a CT scan of the nasal sinuses was ordered. The images revealed a nearly 5 cm mucocele in the left ethmoid-frontal sinus. The lesion had expanded, eroded the orbital bone wall, compressing and displacing the eyeball forward.

CT images show a left ethmoid-frontal sinus mucocele extending close to the orbit, consistent with the patient's eye protrusion. *Hospital provided*

during an examination at Hong Ngoc - Phuc Truong Minh General Hospital, Dr. Saing Pisy, an ear, nose, and throat specialist, assessed the case as complex due to the large tumor's deep location within the sinus system and its proximity to the eye socket. Continued growth of the tumor could increase intraorbital pressure, affecting eyeball movement and vision, and raising the risk of periorbital inflammation.

the medical team opted for endoscopic surgery through the nasal passage to access the lesion, avoiding an external incision. Doctors widened the drainage pathway, removed the mucoid fluid, cleaned the sinus, and relieved pressure on the eye socket. Given the surgical area's proximity to the eyeball and other important structures, all procedures were performed under magnified endoscopic imaging to control the intervention's precise location.

doctors perform endoscopic surgery through the nasal passage to open the sinus and relieve orbital compression. *Hospital provided*

one day after surgery, the boy was alert, resuming normal activities, with no recorded vision complications. He continues to be monitored for the reduction in eye protrusion, eye function, and post-operative sinus patency.

according to Dr. Pisy, sinus mucoceles develop when a sinus drainage pathway becomes blocked, causing mucus to accumulate and gradually expand the sinus. While benign, prolonged pressure can thin or erode bone walls, displacing adjacent structures. Tumors in the ethmoid-frontal sinus may present with ocular symptoms before clear signs appear in the nose or sinuses.

the boy recovers after surgery, with no recorded vision complications. *Hospital provided*

the doctor noted that eye abnormalities sometimes originate from sinonasal conditions, especially when lesions are deep and progress silently. Individuals experiencing progressively protruding eyes, double vision, reduced vision, periorbital pain, eye swelling, or persistent nasal congestion should seek medical attention. Doctors may recommend nasal endoscopy, CT, or MRI, depending on the condition, to identify the cause and initiate treatment before vision and periorbital structures are severely affected.

Van Ha