Paranasal sinus mucucele; clinical presentations and surgical management

Mucoceles of the paranasal sinus are benign expandable lesions that primarily occur between the fourth and seventh decades of life. In this study, the cases diagnosed with paranasal sinus mucocele who were operated by a single surgeon between 2002 and 2019 were evaluated in terms of symptoms, surgical technique, complications, and recurrence and discussed in the light of the literature. In this study, we retrospectively analyzed 75 patients, 76 mucoceles who underwent operations due to paranasal sinus mucoceles between January 2002 and December 2019. In the patients diagnosed with a mucocele, the mucocele was removed surgically. Of the 75 patients, 36 were female and 40 were male. All the patients were between the ages of 21 and 85, with an average age of 56.9 years old. Mucocele formation occurred in the frontal sinus in 46 (61%) patients, the maxillary sinus in 16 (21%) patients the ethmoid sinus in 11 (14%) patients, and the sphenoid sinus in 3 (4%). 1 patient had both frontal and maxillary sinus mucocele. 15 underwent surgery using external approach. All patients were followed-up with endoscopic examinations for 13 months to 4 years. 4 of 76 mucoceles (5,3%) experienced recurrence Treatment of paranasal sinus mucoceles is surgical and usually simple drainage and marsupialization of mucoceles is sufficient. The endoscopic approach in the treatment of sphenoid, maxillary and ethmoid mucoceles is the surgical method of choice without question. However, in frontal sinus mucocele surgery, external surgery is still valid as much as endoscopic sinus surgery.

PDF

___

1. Fu CH, Chang KP, Lee TJ. The difference in anatomical and invasive characteristics between primary and secondary paranasal sinus mucoceles. Otolaryngol Head Neck Surg. 2007;136:621-5.

2. Bockhmul U. Osteoplastic frontal sinusotomy and reconstruction of frontal defects. In: Kountakis S, Senior B, Draf W (eds) The frontal sinus. Springer, Berlin, 2005;281-9.

3. Har-El G. Endoscopic management of 108 sinus mucoceles. Laryngoscope 2001;111:2131-4.

4. Stienberg CM, Bailey BJ, Calhoun KH, et al. Management of invasive frontoetmoidal sinus mucoceles. Am J Otolaryngol. 2007;28:145-7.

5. Soon SR, Lim CM, Singh H et al. Sphenoid sinus mucocele: 10 cases and literature review. J Laryngol Otol. 2010;124:44-7.

6. Herndon M, McMains KC, Kountakis SE. Presentation and management of extensive fronto-orbital-ethmoid mucoceles. Am J Otolaryngol. 2007;28:145-7.

7. 7. Zukin LM, Hink EM, Liao S, et al. Endoscopic Management of Paranasal Sinus Mucoceles: Meta-analysis of Visual Outcomes. Otolaryngol Head Neck Surg. 2017;157:760-6.

8. 8. Plantier DB, Neto DB, Pinna FR, et al. Mucocele: Clinical Characteristics and Outcomes in 46 Operated Patients. Int Arch Otorhinolaryngol. 2019;23:88-91.

9. 9. Khong JJ, Malhotra R, Wormald PJ et al. Endoscopic sinus surgery for paranasal sinus mucocoele with orbital involvement. Eye 2004,18:877-81.

10. 10.Har-El G. Transnasal endoscopic management of frontal mucoceles. Otolaryngol Clin North Am. 2001;34:243-51.

11. 11.Haug GA, Dortzbach RK, Brandenburg J. Tretament of frontal sinus mucoceles with the osteoplastic flap technique. Ophtalmic Surg. 1978 ;9:40-66.

12. 12. Park CM, Stoffella E, Gile J, et al. Osteoplasty Flap Technique for Repair of Latent (30-Year) Post-Traumatic Frontal Sinus Mucocele: Case Report and Review of the Literature J Oral Maxillofac Surg. 2012;70:2092- 6.

13. 13.Courson AM, Stankiewicz JA, Lal D Contemporary Management of Frontal Sinus Mucoceles: A Meta-Analysis. Laryngoscope. 2014;124:378- 86.

14. 14.Serrano E, Klossek JM, Percodani J, et al. Surgical management of paranasal sinus mucoceles: a long term study of 60 cases. Otolaryngol Head Neck Surg. 2004;131:133–40.

15. 15.Meetze K, Palmer JN, Schlosser RJ. Frontal sinus complications after frontal craniotomy. Laryngoscope. 2004;114:945-8.