Primary Mucocele Research Articles

Do Variations in Frontal Recess Anatomy Predispose to Mucocele Formation?

Introduction Mucoceles are benign expansile cystic lesions commonly seen in the frontoethmoidal region. Objective To see if the distribution of frontal air cells predisposes to mucocele formation. Methods Retrospective review of all cases of paranasal sinus mucocele from 2011 to 2021. Data on demographics, history of surgery or trauma, clinical features, radiological findings, and outcome were collected and analyzed. Results Of the 28 cases, 19 (67.9%) were male and 9 (32.1%), female, with a mean age of 40.75 years. Mucocele was unilateral in 26 (92.9%) patients. Twenty patients (71.43%) presented with primary mucocele. The distribution of mucocele was frontal and frontoethmoidal in 8 (28.6%) patients each, maxillary in 6 (21.4%), and ethmoid and sphenoid sinus in 3 (10.7%) patients each. Sixteen (57.1%) patients had frontal sinus involvement. At presentation, 13 (46.4%) patients had nasal symptoms, 17 (60.7%) had orbital symptoms, while 16 (57.1%) had headache. Pain (12; 70.59%) was the predominant orbital symptom, followed by proptosis and diplopia (8; 47.06%). The most common sites of bony erosions were along the frontal sinus floor (14; 50%), followed by lamina papyracea (13; 46.43%), and frontal sinus anterior wall (10; 35.71%). The agger nasi and suprabullar cells were the most common frontal cells encountered in mucoceles involving the frontal sinus, with no significant difference in frontal cell distribution between involved and uninvolved sides. The frontal cell distribution was similar in mucoceles with and without frontal sinus involvement too. Conclusion Though frontal and frontoethmoidal mucoceles were the most encountered, the type and distribution of frontal cells did not predispose to mucocele formation.

Comparative analysis of primary versus secondary paranasal sinus mucoceles: a case control study

Abstract Background Paranasal sinus mucoceles are benign cystic lesions characterized by mucous accumulation that can lead to significant complications due to erosion of sinus walls and compression of adjacent structures. This retrospective study aims to compare the clinical characteristics and treatment outcomes of primary and secondary mucoceles. Methods We reviewed medical records of 68 patients treated for mucoceles at the Ear, Nose, and Throat Hospital in Ho Chi Minh City, Vietnam, from June 2022 to June 2024. Advanced diagnostic imaging techniques, such as computed tomography (CT) and magnetic resonance imaging (MRI), were utilized in the management of these lesions. Statistical analysis was conducted using chi-square and t-tests to compare the characteristics and outcomes between the two groups. Results The study found that primary mucoceles often presented with less severe symptoms compared to secondary mucoceles, which occur post-surgery or post-trauma and are associated with more severe symptoms and complications. Primary mucoceles were most frequently located in the frontal-ethmoid region (47.4%), while secondary mucoceles had a similar distribution but were more prevalent following previous surgical interventions. Endoscopic sinus surgery was the primary treatment for both groups, with secondary mucoceles frequently requiring more complex surgical interventions. Postoperative improvement was significant in both groups, though secondary mucoceles exhibited slower recovery and higher rates of residual minor visual impairments. Conclusion The comparison between primary and secondary paranasal sinus mucoceles reveals critical differences in clinical profiles and treatment outcomes. Understanding these differences is essential for optimizing management strategies and improving prognosis for patients with these challenging conditions. Further research is needed to explore long-term treatment effects and the efficacy of different surgical approaches.

Frontal Mucocele With Proptosis: DrafIIa Approach

Paranasal sinus mucocele commonly involved fronto-ethmoidal region rather than other due to its narrow anatomical drainage outflow, which put them at a higher tendency to get obstructed. Usually, it arises from an identifiable cause such as a history of endonasal surgery, facial trauma or background of nasal allergy or rhinosinusitis. Rarely patient presented with primary frontal mucocele, and its presentation depending on the mucocele location and extension with surrounding mass effect. Treatment is based on restoration of frontal sinus drainage and ventilation or towards a more radical and definitive approach which is sinus obliteration. Risk and benefits between these two need to be taken into consideration. We present a case of primary frontal mucocele with gradual onset of unilateral eye proptosis which first presented solely with ophthalmic symptoms.International Journal of Human and Health Sciences Vol. 05 No. 03 July’21 Page: 366-371

Clinical presentation and treatment of primary and secondary paranasal mucoceles

Background: This retrospective study was conducted to describe and compare the clinical characteristics of primary mucoceles occurring in patients without a previous history of sinus surgery, the cause of mucoceles and secondary mucoceles resulting as a complication following endoscopic sinus surgery, and the Caldwell-Luc operation. Materials and Methods: This study reviewed 18 cases of primary mucoceles and 21 cases of secondary mucoceles, who were diagnosed and had received surgical intervention between 1995 and 2012. Results: The most common presenting symptoms in primary mucoceles were: Visual disturbance (18.6%), nasal obstruction (12.5%), and headache (12.5%). In secondary mucoceles, the most common symptoms were: Nasal obstruction (27.5%), rhinorrhea (15%), and postnasal drip (12.5%). The most common sites of origin for primary mucoceles were the ethmoid sinus (31.5%) and sphenoid sinus (31.5%). In secondary mucoceles, the maxillary sinus was the most common site of origin (40.7%), followed by the ethmoid sinus (29.6%). All patients with secondary mucoceles had a history of sinus surgery. Conclusions: Mucoceles are benign lesions of the paranasal sinus. Cases of secondary mucoceles that occur following sinus endoscopic surgery develop more frequently in the ethmoid sinus compared to those following the Caldwell-Luc procedure. Endoscopic intranasal surgery of mucoceles is a reliable therapeutic measure with a favorable long-term outcome.

Comparison of Clinical Characteristics between Primary and Secondary Paranasal Mucoceles

PurposeParanasal sinus mucocele is a benign, expansile mass which can occur as a result of trauma or spontaneous obstruction of a sinus tract. The purpose of this study was to describe and compare the clinical characteristics of primary mucoceles occurring in patients with no previous sinus surgery history or known cause of mucoceles and secondary mucoceles resulting as a complication following endoscopic sinus surgery or the Caldwell-Luc operation.Materials and MethodsWe performed a retrospective chart review of 33 cases of primary mucoceles and 60 cases of secondary mucoceles which were diagnosed and surgically corrected between 1996 and 2008.ResultsThe most common presenting symptoms in primary mucoceles were nasal obstruction (19.4%) and rhinorrhea (17.7%). In secondary mucoceles, the most common symptoms were cheek pain (31.7%) and nasal obstruction (18.3%). The most common origins of primary mucoceles were the ethmoid sinus (45.5%) and the maxillary sinus (18.2%). In secondary mucoceles, the maxillary sinus was the most common site (86%), followed by the ethmoid sinus (7.1%). All patients with secondary mucoceles had a history of sinus surgery.ConclusionThe maxillary sinus was the most common site of secondary mucoceles while the ethmoid sinus was the most common origin of primary mucoceles. Cases of secondary mucoceles that occurred following sinus endoscopic surgery developed more frequently in the ethmoid sinus than in those following the Caldwell-Luc procedure, therefore, we suggest that the incidence of maxillary sinus mucoceles in the Asian population would decrease as the rate of endoscopic sinus surgery increases.

The difference in anatomical and invasive characteristics between primary and secondary paranasal sinus mucoceles

To evaluate the difference in anatomical and invasive characteristics of primary and secondary paranasal sinus mucoceles. A retrospective chart review at a tertiary academic center. During a 10-year period, 57 and 109 patients with primary and secondary mucoceles were enrolled, respectively. Thirty-five (61.4%) of primary and 26 (23.9%) of secondary mucoceles had intraorbital extension (IOE), while seven (12.3%) of primary and two (1.8%) of secondary mucoceles had intracranial extension (ICE). In comparison of tendency for IOE or ICE between primary and secondary mucoceles in each sinus, only primary maxillary mucoceles were shown to have a significantly higher probability of IOE than secondary maxillary mucoceles. Among primary mucoceles, ethmoid mucoceles had a significantly greater capability to cause IOE while maxillary mucoceles had the least. Among secondary mucoceles, frontal and ethmoid mucoceles had a greater ability to cause IOE while maxillary mucoceles had the least. As for ICE, sphenoid mucoceles had a greater potential in both groups. Primary mucoceles seem to have a greater potential to cause IOE and ICE than secondary mucoceles. In both groups, ethmoid mucoceles have a higher potential of IOE, while sphenoid mucoceles have a greater tendency to cause ICE.

A Case of a Mucocele in an Onodi Cell

Onodi cells have been defined as posterior ethmoid cells that have pneumatized laterally and superiorly to the sphenoid sinus. They are often close to the optic nerve or the internal carotid artery. A patient complained of a sudden decrease in left eye visual acuity and left eye pain due to formation of a primary mucocele in an Onodi cell. A coronal computed tomography scan and magnetic resonance imaging were useful for diagnosing the mucocele.

巨大な原発性蝶形骨洞嚢胞例

We report a case of huge primary mucocele of the left sphenoid sinus. The patient was a 55-year-old male with a one-month history of left visual disturbance. The patient did not have a history of paranasal sinus surgery nor injury. CT and MRI findings demonstrated that the expansive cystic lesion measured about 5cm, and primarily occupied the parapharyngeal space. The interior the lesion appeared uniform and there was no imaging effect. Since the occupation part of this lesion differed from the general part of paranasal sinus mucocele, discrimination between tumor and mucocele was needed. Endoscopic sinus surgery was performed under local anesthesia. Mucus secretions within the mucocele were removed, and a wide opening was made in the nasal cavity. Left visual disturbance gradually improved postoperatively.There have been 88 cases of paranasal sinus mucocele treated at Yoka Public Hospital in the past 11 years. The majority consisted of postoperative maxillary mucocele, whereas primary mucocele comprised only 4 cases. In postoperative paranasal mucocele, the period from the last surgery to symptom appearance was 26.9 years on average. As treatment, surgery was performed on about 70 percent of the paranasal sinus mucocele cases, and about 10 percent were left intact. The period from symptom appearance until surgery was 10.7 months on average, and that was for one week to a maximum of ten years. Many patients had long periods of illness, therefore, it is better to perform surgery when patients have symptoms.

Ophthalmoplegia and ptosis as onset symptoms of an isolated primary mucocele of the sphenoid sinus

J Oral Maxillofac Surg 60:1500-1502, 2002

Mucocele of the petrous apex

The first case of a primary mucocele of the petrous apex is presented and the differential diagnosis is briefly discussed. Since this area is unavailable for direct examination, a thorough radiographic evaluation is essential. A mucocele should be suspected when a lytic lesion has a multiloculated appearance and when the contralateral petrous apex is highly pneumatized. Even then, a biopsy may still be needed to make a definitive diagnosis. The appropriate treatment for these cystic lesions is fistulization into a radical mastoid cavity or an exteriorized sphenoid sinus.