Postoperative mucocele in a pediatric patient

Abstract

Objectives: Postoperative mucocele formation is a known and late complication of endoscopic sinus surgery in adults. Occurrence in the pediatric population, however, is rare and not reported in the American literature. We report a case of a mucocele in a child after endoscopic sinus surgery. Methods: A 9-year-old female presented with a 1-month history of proptosis. She denied any headache, eye pain, visual disturbance, nasal obstruction, or rhinorrhea. A CT scan of the orbits revealed a 2.1 ± 1.7 cm expansile soft tissue mass within the left anterior ethmoid air cells, with displacement and thinning of the lamina papyracea. She had a history of endoscopic sinus surgery 3 1/2 years ago. Results: She underwent endoscopic exam under general anesthesia and a large mucopyocele was identified, involving the ethmoid sinus and left medial orbital wall. The lamina papyracea was eroded. Endoscopically the mucopyocele was removed. The patient did well postoperatively. At 3 weeks follow-up, her proptosis was improved and there was no evidence of synechia. Conclusion: Pediatric mucoceles of the paranasal sinuses are a rare entity with little reported in the literature. Furthermore, there are no studies in the American literature describing postendoscopic sinus surgery mucoceles in children. With the increasing numbers of pediatric endoscopic sinus procedures, there needs to be an awareness of this entity as a long-term postoperative complication. Treatment of mucoceles in children has been described, and like adults, endoscopic drainage is recommended.