We report a unique case of a mucocele of a pneumatised uncinate process.

Clinical, radiological and intra-operative findings are presented.

A 43-year-old woman was referred to our ENT department suffering from persistent symptoms of left-sided sinusitis. Although an initial computed tomography scan suggested a lacrimal duct mass, dacrocystography showed free flow through the nasolacrimal duct. The patient underwent surgery, revealing a mucocele within a pneumatised uncinate process.

This patient's clinical, radiological and intra-operative findings illustrate how variations in sinus anatomy can pose a diagnostic challenge.

We describe a previously unreported case of ethmoid silent sinus syndrome.

Case report and review of the world literature regarding silent sinus syndrome.

A 33-year-old woman developed medial displacement of the left orbital contents in the absence of trauma, surgery or other significant pathology. Imaging showed opacification of the left ethmoid sinus and implosion of the medial orbital wall. Previously reported cases of silent sinus syndrome have all involved the maxillary sinus, with subsequent implosion of the orbital floor. Computed tomography scans of our patient showed wide, flat ethmoidal bulla and surrounding cells, with few horizontal bony septae reinforcing the area of collapse.

This case represents the first report of ethmoid silent sinus syndrome. We argue that, in anatomically susceptible individuals, the silent sinus syndrome can present due to chronic ethmoidal sinusitis.