ORBITAL HYDATID CYST SECONDARY TO TRAUMATIC MANDIBULAR INVOLVEMENT: RAPID PROGRESSION AND SURGICAL MANAGEMENT

Mowaffaq Khaled Alkassasbeh, MD, Fawaz Hayel Alzweimel, MD*, Yazan Tayseer Altarawneh, MD, Abdolah Abdelaziz Maaita, MD, Mutaz Naiel Alsaraira, MD.

ABSTRACT

Background: Hydatid disease is a zoonotic infection caused by the larval stage of Echinococcus granulosus. The liver and lungs are common locations, but involvement of craniofacial bones or orbit is a rare presentation. In endemic regions, post‑traumatic swellings may mask an underlying hydatid disease. Case Presentation: A 17-year-old shepherd initially presented to the maxillofacial department with right mandibular condyle swelling and proptosis after trauma. Incisional biopsy resulted in a hydatid cyst, but patient’s father refused definitive treatment. Approximately one year later, the patient presented to the oculoplastic clinic with severe proptosis, diplopia, and progressive visual loss. Imaging demonstrated a multiloculated cyst extending from the mandibular fossa into the orbit and compressing the optic nerve. Urgent anterior orbitotomy was performed to remove the lesion and decompress the optic nerve. Conclusion: Hydatid disease can present in unexpected parts of the head and face. In our experience, Early removal of the cyst, careful irrigation with scolicidal agents during surgery and a course of antiparasitic therapy led to a good result with decreased chance of cyst recurrence.

Keywords: Orbital Hydatid disease, Echinococcus granulosus, larva stage, hydatid cyst, proptosis.