Mucoceles of the Paranasal Sinuses: A 10 Year Single Institution Review

Abstract

Mucoceles of the Paranasal Sinuses: A 10 Year Single Institution Review Background: Mucoceles are epithelial-lined, mucous-containing, cysts related to compromised sinus ventilation via blockage of the sinus outflow tract or entrapment of mucosa in a fracture line. Mucoceles may lead to thinning of surrounding bone and extension beyond the sinus walls into adjacent structures causing complications. The aim of this study is to review the incidence, risk factors and treatment of paranasal sinus mucoceles in a single academic institution over a decade. Methods: This is a retrospective chart review of patients who developed sinonasal mucoceles. The records were reviewed. The variables analyzed were age, gender, site of mucocele, symptoms and signs, past medical history, radiologic findings, patency of the sinus outflow tract, and method of treatment. Results: Forty-two patients with mean age of 54 years were identified during the study period. The frontal sinus was the most common location for mucocele formation. Chronic rhinosinusitis was the most common risk factor predisposing to mucocele formation. Of those with frontal mucoceles a history of craniofacial trauma was the most common risk factor. Of patients with a history of prior surgery the frontal sinus was the most common location of mucocele formation. This was statistically significant (P<0.05). It took on average 15 years for a mucocele to develop after craniofacial trauma. Eight (36%) out of 22 frontal mucoceles were treated with endoscopic sinus surgery. All patients that had a follow up were found to have clear sinuses and patent outflow tracts. The maximum follow up period ranged from 2 to 72 months with a mean of 17 months. Conclusion: Frontal sinus is the most common site for mucocele formation in the setting of craniofacial trauma. Patients have an increased risk of developing sinus mucocele years to decades after sustaining trauma. Such delayed development means that longer follow-up is needed for craniofacial trauma.