Eosinophilic mucin chronic rhinosinusitis with orbital involvement: management strategies based on clinical presentation

Allergic fungal sinusitis (AFS) and eosinophilic mucin chronic rhinosinusitis (EMCRS) are subtypes of a chronic rhinosinusitis with eosinophilia that have different diagnostic criteria but are phenotypically similar. Ophthalmic complications may be the presenting symptoms. Treatment of ophthalmic complications is typically directed at reducing the inflammatory burden in the sinuses and rarely requires direct surgical intervention. However, atypical cases with associated subperiosteal abscess may necessitate orbital surgery. The authors present 2 cases of EMCRS with orbital involvement – one that responded to the traditional treatment of oral corticosteroids and functional endoscopic sinus surgery (FESS), and the other requiring surgical drainage of a subperiosteal abscess in order to describe the management strategies based on clinical presentation.