Frontoethmoidal Mucocele Research Articles

Telecanthus as a Presenting Sign of a Fronto-Ethmoidal Mucocele in an Eleven Year-Old

An eleven year-old girl with no prior history of trauma, sinusitis, or cystic fibrosis presented with an isolated sign of recent onset telecanthus, which was not present in photographs from two years prior. Orbital CT-scan showed a fronto-ethmoidal mucocele. The patient was referred to an ear, nose and throat surgeon, who performed an endoscopic drainage and marsupialization of the mucocele. Although mucoceles most commonly present in adults with proptosis, headache, diplopia, globe displacement, and/or epiphora, this case illustrates that it may also uncommonly present in the pediatric population as telecanthus.

Frontoethmoidal Mucocele with Unilateral Proptosis

ABSTRACTFrontoethmoidal mucocele can present with a multitude of different symptoms including ophthalmic disturbances. Though benign, they have a tendency to expand by thinning the bony walls. They displace and invade surrounding structures by pressure and bony resorption. If it invades the orbit and continues to expand, the mass may mimic the behavior of many benign growths arising primarily in the orbit. We report a case of a frontoethmoidal mucocele extending into the orbit. Clinically, the patient had an insidious onset of clinical presentation with no intracranial symptoms.

Trauma Induced Complete Sinonasal Separation and Subsequent Frontoethmoid Mucocele Formation

She was initially treated with intravenous antibiotics and quickly defervesced, but recurred when transitioned to oral antibiotics. Given the refractory nature of her disease the decision was made for surgical intervention. Using a combined endoscopic and extended lynch incision approach, an artificial drainage pathway was successfully created to the nasal cavity. Initially intraoperative endoscopic examination revealed no identifiable landmarks. Correlating the intra-operative findings with the most recent CT scan, a connection between the frontal sinus and nasal cavity was made using transillumination from above and below. A #4.5 endotracheal tube sutured to the nasal septum was utilized to stent the neonasofrontal duct. (figure 5) The patient did well post-operatively and was seen in clinic prior to discharge. The nasal stent was cleaned and irrigated, and confirmed to be in good position. She was discharged on POD# 4. On returning for follow up visit at 6 weeks, the stent was noted to have fallen out. She is currently 7 months post operative and continues to do well.

Orbital subperiosteal hematoma associated with sinus infection

There are few reports of orbital subperiosteal hematomas as a result of sinusitis complications. The present study reports on 2 such cases and presents a literature review regarding this condition. We report 2 cases of orbital subperiosteal hematoma, and reviewed previous literature reports. Including the 2 current patients, 11 cases of orbital subperiosteal hematoma involving sinusitis appear in the literature. The current cases involved 2 older females presenting with proptosis. One had frontal sinusitis and the other a postoperative frontoethmoid mucocele. Both patients underwent a superior orbitotomy and sinus surgery, which resolved the orbital symptoms. Orbital subperiosteal hematomas can develop associated with sinus infection. Such a condition should be treated as a sinusitis complication and the associated sinus infection must be treated concomitantly.

Surgical management of chronic rhinosinusitis in North Western Nigeria and challenges for the future

Rhinosinusitis is usually treated medically. Surgical management is indicated when medical treatment fails or becomes complicated. Appraisal of various surgical methods employed in the treatment of chronic rhinosinusitis is the subject of this paper from a University teaching hospital in north western Nigeria. This is a review of 75 patients who underwent various conventional surgical operations for rhinosinusitis over a 5.5 year period from September 1999 to February 2005 who were followed up for a minimum period of 2 years. A total number of 177 surgical operations were carried out of which 75 patients either had some surgical procedures unilaterally, bilaterally or in combinations. There were thirty nine males (52%) and thirty six females (48%) with a male to female ratio of 1:1. Their age ranges from 8 years to 70 years with a mean of 31.1 years. The ages 21-40 years range constituted majority (65.3%) of the patients. Ninety-two operations (52%) were caldwell luc (CWL) which was the commonest operation followed by forty-one (23.2%) cases of inferior meatal antrostomy (IMA), thirty two (18.1%) cases of partial inferior anterior turbinectomy (PIT), Ten (5.6%) cases of frontoethmoidectomy (FTE) and Two( 1.1%) cases of submucous resection of the septum (SMR). The indications for surgery were mainly persistent symptoms despite adequate medical treatment with radiologically confirmed evidence of ninety-seven nose or sinus pathologies in the seventy-five patients operated. These were: Chronic rhinosinusitis (CRS) with snus opacity in fifty four (55.7%) cases, CRS with polyps in eighteen (18.6%) cases, CRS with hypertrophic turbinates causing nasal obstruction in sixteen (16.8%) cases, CRS with frontoethmoidal mucoceles in five (5.2%) cases and CRS with sino-cutaneous fistula in two (2.1%) cases. Paraesthesia of the upper incissors was the commonest complaint after surgery for chronic maxillary sinusitis but at the fronto-ethmoidal region after frontoethmoidectomy which usually improved gradually and eventually disappeared between 3 to 6 months. Symptom relief after surgery justified surgery in all patients while one case needed a revision surgery after two and a half years for a recurrent symptom. There has not been any need for further surgery for the rest of the cases after a minimum period of 2 years follow up. Surgical management of rhinosinusitis in north western Nigeria was mainly for chronic rhinosinusitis and proved to be beneficial for relief of symptoms with minimal complications if patients are carefully selected either with failed medical treatment or with complications. The young population of twenty-one to forty years (65.3%) constituted the bulk of the patients with a peak at the 3rd decade anda mean age of 31.1 years.

Visual Outcomes in Patients With Paranasal Mucoceles

To describe the ophthalmic complications and visual outcome of patients with paranasal mucoceles. This is a retrospective case series of patients with a diagnosis of paranasal mucocele. Their medical records were examined with particular emphasis on the location of the paranasal mucoceles, presence of inflammation (mucocele vs. pyelocele), presence of optic neuropathy, and final visual outcome. Ten patients with an average age of 57.6 years (range, 30-71 years) were studied. Seven mucoceles were in the frontal or fronto-ethmoidal sinuses, one was in the sphenoidal sinus, one was within an Onodi cell, and one was in the maxillary sinus. Four patients developed optic neuropathy, of which 2 cases were related to fronto-ethmoidal mucoceles. Four patients had pyeloceles. Two of these 4 patients had resultant loss of light perception: one case was associated with a fronto-ethmoid sinus and the other with an Onodi cell). Our series highlights the greater risk of optic neuropathy and poor visual outcome with sphenoid sinus and Onodi cell mucoceles because of their proximity to the optic nerve. However, fronto-ethmoidal mucoceles are not benign and may compromise vision, especially if a posterior ethmoid component is present, or if treatment is delayed and secondary infection has ensued to form a pyelocele. Management of paranasal mucoceles should be prompt, particularly when signs of inflammation are present.

Our own method for reduction and obliteration of the cavity in cases of frontoethmoidal mucocele

The frontoethmoidal mucocele engaging the orbit and neighboring structures is relatively uncommon. The presented case uses operative treatment with coronal approach in which for reduction and obliteration of the cavity and the nasofrontal canal the author uses his' own method of a flap that consists of periost and galea aponeurotica. The article describes the sequence of the treatment and the operation. The case report confirms a very good postoperative result and lack of recurrence thirty six months after surgery. The author is reviewing the contemporary literature and the clinical approach with this disease. Scripta Scientifica Medica 2008; 40(2): 157-160.

Frontoethmoidal mucocele with orbital and intracranial extension

We report a case of a giant frontoethmoidal mucocele extending to the orbit and anterior cranial fossa. Clinically, the patient had an insidious onset of clinical presentation with no intracranial symptoms. We present its CT, MRI and histpathological features with a brief review of literature. Various surgical approaches are also discussed.

Frontoethmoidal Mucoceles: CT and MRI Evaluation

Paranasal sinus mucocele is an expanded, airless, mucus-filled sinus caused by obstruction of the sinus ostium. It is a benign slow growing epithelial lined lesion, bulging against adjacent anatomical structures, without infiltrating them. The purpose of our study is to describe the CT and MR findings in 19 patients (ten women, nine men, 18-72 years, mean age: 48.1) with surgically confirmed frontoethmoidal mucoceles between 1999-2005. CT scans displayed mucoceles as non enhancing soft tissue density lesions, generally isodense to the brain parenchyma, expanding the sinuses in most cases, eroding adjacent bones and extending intraorbitally or intracranially. Signal intensity in T2WI and T1WI MR images varied, but generally lesions had high signal intensity in T2WI and low to intermediate signal intensity in T1WI. Some of the lesions demonstrated regular linear peripheral enhancement after administration of contrast medium. The causes of mucoceles included mucosal thickening from chronic sinusitis, adhesions from previous operation in the nasal cavity, previous trauma, small nasal polyps and a small osteoma, while in six patients (31.5%) the cause of the mucocele remained unrecognized even after surgery. No underlying malignant tumor was found in any of the cases as the cause of obstruction. CT and MRI established the correct diagnosis in all patients. CT was more sensitive in determining bone erosions, while MRI had the advantage of multiplanar imaging and was much more sensitive for differentiating mucocele from a tumor on the basis of MR signal intensity characteristics. In conclusion, CT and MRI are the methods of choice for diagnosing mucoceles of the paranasal sinuses and are of major importance for the treatment plan. Each method seems to have its own advantages and should be used as complementary investigations of sinonasal pathology. Enhanced CT scan should only be performed in the absence or contraindication for enhanced MR imaging.

Management of Frontoethmoidal Mucoceles With Orbital Extension: Is Primary Orbital Reconstruction Necessary?

Sinus mucoceles with orbital extension are often managed primarily by an otolaryngologist to relieve the sinus obstruction. In this study, a series of patients was examined to determine whether or not reconstruction of the orbit was necessary at the time of the initial sinus surgery from the perspective of an orbital surgeon often involved in the comanagement of orbital complications of sinus mucoceles. A retrospective interventional case series of 5 patients with frontoethmoidal mucoceles comanaged by otolaryngology and oculoplastics. We reviewed symptoms, clinical findings, course, and treatment of our patients and reviewed the literature regarding management options for frontoethmoidal mucoceles. In extended follow-up, clinical resolution of presenting orbital symptoms and radiographic evidence of reformation of the bony orbit was noted without the need for orbital reconstruction at the time of the initial sinus surgery for a sinus mucocele with orbital extension. A specific subset of sinus mucoceles with orbital extension may resolve by primary sinus surgery alone. A decision on the relative merits of orbital surgery at the time of primary sinus surgery should be made on a case-by-case basis.

Benign Fibrous Histiocytoma Associated With a Frontoethmoidal Mucopyocele and Orbital Abscess

A 74-year-old man sought treatment for painful swelling in the right upper eyelid. CT demonstrated a frontoethmoidal mucocele extending in the right orbit with abscess formation. Following functional endoscopic sinus surgery, the inflammatory symptoms in the right eye nearly resolved. However, a firm mass was still noted in the same location. Histopathologic examination proved it to be a benign fibrous histiocytoma. Benign fibrous histiocytoma may occur in association with an orbital abscess secondary to mucocele.

Frontoethmoidal mucocele associated with bilateral increased intraocular pressure and proptosis

Case report: We describe the case of a 53-year-old man presenting with bilateral proptosis and raised intraocular pressure. Computed tomography imaging revealed these signs to be secondary to a frontoethmoidal mucocele with bilateral orbital invasion.Comments: Bilateral increased intraocular pressure is unusual in cases of frontoethmoidal mucoceles, but prompt imaging and treatment can prevent permanent visual loss.

Frontoethmoidal mucocele associated with bilateral increased intraocular pressure and proptosis

Frontoethmoidal mucocele associated with bilateral increased intraocular pressure and proptosis

Frontoethmoidal mucocele associated with bilateral increased intraocular pressure and proptosis

Frontoethmoidal mucocele associated with bilateral increased intraocular pressure and proptosis

Fronto-Ethmoidal Mucocele after Coronal Orbital Decompression

A patient who underwent coronal orbital decompression for Graves' orbitopathy eight years earlier presented with left-sided proptosis without signs of periorbital inflammation. Computed tomography imaging showed a fronto-ethmoidal mucocele. It is suggested that this mucocele may be a late complication of decompression surgery.

Primary frontal sinus aspergillosis: an uncommon occurrence

Primary frontal sinus aspergillosis is extremely uncommon with only few cases reported in the English literature. Isolated frontal sinus aspergillosis is usually asymptomatic and produces symptoms due to orbital or intracranial involvement. We report two cases of primary frontal sinus aspergillosis, presenting as frontoethmoidal mucocele and mimicking a 'Pott's puffy tumor,' respectively. Forehead swelling produced by frontal sinus aspergillosis will be the first to be reported in the English literature.

Aspectos técnicos en cirugía endoscópica de mucopiocele frontal

AbstractThe term mucocele is applied to define a chronic, expanding, mucosa-lined lesion of the paranasal sinus characterized by mucous retention that can be infected becoming a mucopyocele. Until recently the majority of patients with frontoethmoidal mucoceles were treated through an external approach, however, selected cases of mucoceles can be approached endoscopically, decreasing the morbidity associated to external approaches. We report the case of a frontal mucopyocele with rapid expansion and erosion of the anterior wall. Surgical aspects and postoperative follow-up are described.

Fronto-ethmoid mucocele: an unusual presentation

Mucoceles arising from the sinuses usually present with proptosis and displacement of the globe. Posterior orbital invasion can occasionally present with ophthalmoplegia or ptosis. This communication discusses an unusual presentation of a fronto-ethmoid mucocele presenting as a fistula in the upper lid. The diagnosis was based upon the computerised tomographic scan of the paranasal sinuses. The patient subsequently underwent surgical excision of the mass, which relieved his symptoms.

Frontoethmoidal Mucocele with Intracranial Extension: A Case Report

Mucoceles with intracranial extension are often reported by otolaryngologists and neurosurgeons. The authors present a case of a large frontoethmoidal mucocele with intracranial and intraorbital extension exerting a mass effect on the anterior cranial fossa. The patient experienced spontaneous drainage of the mucocele without evidence of recurrence of the lesion after a one-year period, suggesting that mucoceles, regardless of size, can be treated with conservative procedures such as functional endoscopic sinus surgery.

McCune-Albright syndrome (polyostotic fibrous dysplasia) with intracranial frontoethmoid mucocele

McCune-Albright syndrome (polyostotic fibrous dysplasia) with intracranial frontoethmoid mucocele