Frontal Sinus Mucocele After Osteoplastic Flap Surgery: Case Report

Peter Catalano,Michael Schlewet

doi:10.26502/acmcr.96550013

Abstract

A mucocele of paranasal sinuses is a collection of mucus within an epithelial lined sinus whose outflow tract is permanently obstructed. The most common site for a mucocele is the frontal sinus; it is less common in the other sinuses. Frontal mucoceles present in different ways depending upon their size and duration, with symptoms often gradual and insidious. Symptoms are mainly ophthalmic and include proptosis and diplopia. The diagnosis is established by history, physical exam, and imaging studies (primarily Computerized tomography of the paranasal sinuses). Herein, we present a case of a frontal mucopyocele (type 5a) that occurred 25 years after a frontal sinus osteoplastic flap operation. Successful treatment involved endoscopic marsupialization followed by the use of a drug-eluting sinus stent to maintain ostial patency during the early post-op phase.

Highlights

1.1 Mucoceles in paranasal sinuses 1.1.1 Definition and etiology: A mucocele is mucoid secretion trapped within an epithelial lined sinus that has a completely blocked outflow tract
Paranasal sinus mucoceles represent a collection of mucus in an epithelial lined sinus with an obstructed outflow tract
The rate of expansion of paranasal sinuses mucoceles may be accelerated by secondary infection [7], and acute onset of pain, headache, swelling, or facial pressure can accompany the otherwise chronic symptoms

Summary

Introduction

1.1 Mucoceles in paranasal sinuses 1.1.1 Definition and etiology: A mucocele is mucoid secretion trapped within an epithelial lined sinus that has a completely blocked outflow tract. Their tendency for expansion and destruction of the surrounding structures [1] occurs as the epithelial lining continues to secrete mucous into this closed space. If a mucocele becomes infected, it is called mucopyocele. Sinus outflow obstruction may be secondary to recurrent sinus infections, allergic rhinitis, inflammatory conditions (Wegener, cystic fibrosis), previous trauma/sinus surgery, or benign tumors (osteoma or fibrous dysplasia) [3]. Mucopyoceles are usually a polymicrobial combination of aerobic and anaerobic bacteriology [4]

Clinical and radiological features

Classification of frontal mucocele

Management

Case Report

Findings

Discussion