Frontoethmoidal Mucocele Research Articles

Mucoceles: a neurosurgical perspective.

The neurosurgical manifestations in three patients with sphenoid sinus mucoceles and two others with fronto-ethmoidal mucoceles are presented. In two patients, sphenoid sinus mucoceles produced visual loss while in the other severe headache was the only symptom. Both patients with fronto-ethmoidal mucoceles presented with proptosis. All patients had surgical treatment. While other symptoms were relieved following treatment, visual loss remained unchanged in both patients in whom it was present. We recommend a high level of suspicion for mucoceles as a cause of sudden or progressive visual loss. Prompt surgical therapy is needed to achieve good visual outcome.

Skull Base Malignancy following Long-Term Sinus Mucocele and Osteomyelitis

A case of skull base malignancy following long-term sinus mucocele is presented. While the similarity in clinical signs between sinus mucocele and malignancy has recently been emphasized in the literature, no previous case of skull base malignancy following frontoethmoid mucocele has been reported. The literature is reviewed and the association between inflammatory conditions and sinus malignancy is outlined.

眼か内壁骨折と遅発性前頭・し骨部位嚢胞について

Twenty-one cases of isolated medial orbital wall fractures were reported and CT findings by coronal planes were evaluated as to the effects of fractures upon the ethmoidal cells and nasal meati. Three coronal planes, which respectively contain such structures as Agger nasi, Pars membranacea and superior meatus, were selected for the study. The extent of fracture was evaluated by dividing the medial wall into three equal portions, i.e., superior, middle and inferior. The prolapsed volume was evaluated in three classes of occupying 1/3, 2/3 and 3/3 of the ethmoid. The presence of soft tissue density was recorded at the three surfaces, upper, medial and lower, around the prolapsed orbital content. The extent of the fracture was most often seen in such cases as involving all the three divisions in 41.3%. The prolapsed volume occupying 1/3 was seen in 28, 6%, and 2/3 in 23.8%. The presence of soft tissue density was seen in 38.1% of upper surface, in 36.5% of medial, and 11.1% of lower. Summarizing the total effects of the fractures, the coronal plane containing Pars membranacea was most severely damaged followed by the plane of the superior meatus. Two rare cases of fronto-ethmoidal mucoceles, caused by the traumas of 23 and 14 years before respectively, were also included and reported. The ophthalmological prognosis was favorable in 90.5% of cases by observations extending more than 6 months. Five cases were surgically treated including two cases of mucoceles.(ABSTRACT TRUNCATED AT 250 WORDS)

Prostaglandin synthesis in the pathogenesis of fronto-ethmoidal mucoceles.

The fronto-ethmoidal mucocele is a rare condition capable of expansion and erosion of bone. Its etiology is attributed to obstruction of the fronto-nasal duct and inflammation. To elucidate the role of inflammation, mucocele fragments and fibroblasts cultured from them were examined in vitro to assess prostaglandin E2 synthesis. The cultured fibroblasts when stimulated with mononuclear cell culture supernatant produced significant levels of prostaglandin E2 and collagenase, compared with normal frontal sinus mucosa fibroblasts removed at craniotomy. These significantly elevated mucocele levels of prostaglandin E2 (p = less than 0.001) suggest that lining fibroblasts are a major source of bone-resorbing factors, acting under the stimulus of lymphocytes and monocytes and which operate at the mucocele-bone interface, facilitating expansion. This situation closely parallels that already established in odontogenic cysts.

The Lynch-Howarth Operation and Unilateral Sinus Disease-Reply

In Reply .—All 60 cases of frontoethmoidal mucoceles in our series were unilateral, a point of considerable interest when considering etiologic factors that are often bilateral in their effect. In a recently completed series of 100 cadaver dissections, the incidence of naturally occurring patent intersinus septa was found to be 10% This may occasionally provide an alternative pathway of drainage and may in part explain why mucoceles do not result in all cases of frontonasal duct obstruction. However, while a surgically performed intersinus septectomy is an important component in the treatment of an established frontoethmoidal mucocele, it would be inadequate alone. Apart from the necessity of dealing with any associated ethmoidal pathology, to eradicate the mucocele and prevent recurrence, it is necessary to completely strip the lining mucosa, thereby overcoming the inflammation and bone resorption at the mucocele/bone interface. Since an external operation is therefore necessary, the Lynch-Howarth frontoethmoidectomy offers

Aetiology and treatment of fronto-ethmoidal mucocele.

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