Orbital mucocele
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.
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
July 2003
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 or acetylcystein) 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.
Operation
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.
Day after the operation
Day 4—home again!
Looking like he’s been in a fistfight...
Recovery
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 5—38 days left
(and counting)
May 13—free at last!