Sinus Mucocele Research Articles

Spontaneous Resolution of Diplopia Related to a Frontal Sinus Mucocele.

Xie, Jim S. BHSc; Micieli, Jonathan A. MDEditor(s): Avery, Robert DO; Golnik, Karl C. MD; Froment, Caroline MD, PhD; Wang, An-Guor MD Author Information

Acrylic bone cement with Tutopatch for frontal sinus obliteration.

To evaluate the use of acrylic bone cement with a Tutopatch collagen implant for frontal sinus obliteration after mucocele excision using a subjective assessment of patient satisfaction. Patients with a recurrent frontal sinus mucocele with posterior table erosion, for whom an endoscopic approach was not feasible, and who underwent osteoplastic frontal sinus obliteration, were included. The post-operative outcomes were evaluated using a non-standardised questionnaire, comparing pre- and post-operative scores. All patients expressed post-operative satisfaction. Except for hyposmia, significant improvements were observed in all symptom scores. No major complications were observed during the post-operative course. Acrylic bone cement with Tutopatch can be effectively used in frontal sinus reconstruction in cases where an endoscopic approach is not feasible.

Scuba Diver Presenting with a Giant Sphenoid Sinus Mucocele

Scuba Diver Presenting with a Giant Sphenoid Sinus Mucocele

Compression optic and oculomotor neuropathy caused by misdiagnosed sphenoid sinus mucocele

We herein describe the case of a 60-year-old man who complained of headache and inability to open his left eye. Four years ago, he was admitted to a hospital because of the loss of vision in his left eye. Without adequate radiological examination, he was misdiagnosed with ischemic optical neuropathy and treated with glucocorticoid and neurotrophic drugs, but his vision did not improve. After sphenoidostomy under local anesthesia in time, his headache disappeared and his left eye could be opened immediately. We herein report this case to emphasize the relationship between the optic and oculomotor neuropathy and paranasal sinus disease.

Применение расширенной эндоскопической фронтотомии у пациентки c рецидивирующим мукоцеле лобной пазухи

A clinical case in patient with a recurrent frontal sinus mucocele is described. An extended endoscopic frontotomy of the Draf IIb type was performed; a mucoperiosteal flap was used to prevent postoperative stenosis of the neo-ostium. However, within a year after the intervention, ostium stenosis developed with recurrence of the mucocele due to severe hyperostosis, which required repeated surgical treatment. The method of choice was an extended frontotomy of the Draf III type using a combination of pedicled flap and free mucosal graft to reduce the risk of restenosis of the frontal sinus ostium.

부비동 내시경 수술 후 발생한 전두동 점액농류 1예

Mucocele is a mucus-containing benign lesion, whose clinical characteristic of slow expansion may lead to erosion and remodeling of the bony sinus walls. When the internal content of the mucocele becomes infected, the lesion is called mucopyocele. The etiology of mucocele formation is multifactorial including inflammation, allergy, trauma, anatomical abnormality, previous surgery, fibrous dysplasia, osteoma, and ossifying fibroma. During the past decades since the introduction of endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS), paranasal sinus mucoceles following ESS have been increasingly reported. However, giant mucopyoceles of the frontal sinus expanding cerebral parenchyma are extremely rare. In this case report, we describe a case of huge frontal sinus mucopyocele compressing left frontal lobe after ESS, which was successfully treated by wide marsupialization via the transnasal endoscopic approach. (J Clinical Otolaryngol 2021;32:276-280)

A Case Report of 41-Year-Old Female with Fibrous Dysplasia Combined with Ethmoid Mucocele

Fibrous dysplasia (FD) is a non-malignant progressive condition, which replaces normal bone and marrow with fibrous tissue and woven bone. Sinus mucocele is a cystic, expansile, and destructive lesion that occurs as a result of obstruction of the sinus ostium secondary to inflammation, trauma, anatomical variation, previous sinus surgery, tumor or FD. Among them, FD combined with mucocele has been rarely reported. Here we report the first case of FD combined with ethmoid mucocele. The patient underwent endoscopic debulking of FD and marsupialization of mucocele. The mucocele was successfully marsupialized, and the patient’s symptoms were completely resolved. We propose a new hypothesis that nasal mucosa invaginates into FD and forms a mucocele. For the treatment of ethmoid FD combined with mucocele, we recommend an endoscopic transnasal approach for debulking and marsupialization.

CBCT IMAGING OF “SILENT SINUS SYNDROME”—CASE REPORTS AND LITERATURE REVIEW

<h3>BACKGROUND</h3> Silent sinus syndrome (SSS) is familiar to otolaryngologists and ophthalmologists but is a rare clinical entity in dentistry and likely to be underdiagnosed because of lack of awareness. It presents a diagnostic challenge to dentists because patients typically have no history of trauma or sinusitis. The exact pathophysiology of SSS is still debated. Here we report 3 cases of SSS in adults. <h3>CASE REPORT</h3> As documented in cases reviewed at our institution, the typical feature of SSS is a gradual retreat of the maxillary sinus walls resulting in enophthalmos and hypoglobus. Analysis of axial and coronal cone beam computed tomography (CBCT) sections displayed characteristics such as unilateral volume loss in the maxillary sinus, retracted sinus walls, partial to complete soft tissue opacification of the affected maxillary sinus, and inferior bowing of the orbital floor. The radiographic differential diagnosis of SSS includes congenital maxillary sinus hypoplasia, chronic sinusitis, mucocele, and changes seen after maxillary sinus and orbital trauma. Some of the distinguishing features of congenital maxillary sinus hypoplasia include arrest of development of sinuses due to infection or trauma, congenital first arch syndrome, and other developmental anomalies. Congenital anomalies such as Treacher Collins syndrome are associated with unilateral maxillary sinus hypoplasia. All features of maxillary hypoplasia were absent in the presented 3 cases. <h3>DISCUSSION/CONCLUSIONS</h3> This report highlights the incidental finding of a relatively rarely reported and often underdiagnosed sinus pathosis on CBCT, SSS. Furthermore, the literature review underlines features observed on a higher spatial resolution modality with significant reduction in radiation doses. It is important for dental professionals to recognize the existence of SSS in otherwise asymptomatic patients and institute management where needed.

Association between the insertion type of the uncinate process and the development of Frontal Sinus Mucoceles - is there a relationship?

BackgroundThe frontal sinus drainage pathway is formed by either the ethmoid infundibulum or the middle meatus, which depends on the superior insertion of the uncinate process. According to Landsberg & Friedman the are 6 types of superior uncinate process insertion.The aim of this study is to find an association between the uncinate process insertion type and the development of frontal sinus mucoceles. MethodsFifty sinus CT scans were analysed. Exclusion criteria were previous nasal surgeries, malignancy, polyposis and an insufficient image quality. Superior insertions of the uncinate process were analysed according to the Landsberg & Friedman classification. The results were tabulated and analysed using SPSS 25.0. ResultsThe analysis revealed type 1 insertion in 6% of the CT scans, type 2 in 32%, type 3 in 26%, type 4 in 0%, type 5 in 28% and type 6 in 8%. Despite 44% of the CT scans with frontal sinus mucocele showing a type 2 insertion of the uncinate process, both the Chi-Square test and the Cramer's V test showed no statistical significance (p>.05). Logistic regression also showed that uncinate process insertion type does not influence the likelihood of development of frontal sinuses mucoceles. ConclusionsThe insertion of the uncinate process does not influence the development of frontal sinus mucoceles.

Postoperative ethmoid sinus mucoceles: Late complication of endoscopic ethmoidectomy and MWA management in outpatient

ObjectiveThe aim of this study was to investigate the feasibility of intranasal endoscopic microwave ablation (MWA) on the management of postoperative ethmoid sinus mucoceles. Methods and materialsThe patients with postoperative ethmoid sinus mucoceles were ablated through intranasal endoscopic MWA. Postoperative pain intensity was measured via visual analogue scale (VAS), post-operative complications were recorded. ResultsOf the 26 patients with unilateral postoperative ethmoid sinus mucoceles, the mucoceles were diagnosed 3 to 11 years with average time of time of 6.9 ± 2.7 years after endoscopic ethmoidectomy. The ipsilateral middle turbinate was present and intact in 24 patients and partially resected during the original surgery in the remaining 2. There were adhesions in the middle meatus in one case. All 26 patients were successfully treated with the intranasal endoscopic ablation technique in outpatient. The ablation time was 6 to 11 min, with an average duration of 6.84 ± 1.27 min. The mean VAS pain score was 2.41 ± 1.22. There were no perioperative complications reported in this series. No evidence of recurrence was observed in any patients during follow-up periods. ConclusionsThe present study demonstrates the safety and efficacy of intranasal endoscopic MWA in the office. The procedure is well tolerated by patients with low complication rates. Thus, it is alternative to conventional endonasal endoscopic marsupialization for treatment of postsurgical ethmoid sinus mucoceles.

MAXILLARY MUCOCOELE A RARE ENTITY

Abstract Mucoceles are accumulations of trapped mucus, forming cystic expansile lesions. Maxillary sinus mucoceles are rare amongst paranasal sinus mucoceles, usually being a late sequel of Caldwell-Luc surgery. We present a case of a maxillary sinus mucocele due to a molar root canal treatment in a middle aged patient, reported to highlight its unusual etiology. Keywords Mucocele

Combined Surgical Approach in the Treatment of Oculoorbital Complications of Frontal Sinus Mucocele: A Case Report

Abstract Paranasal sinus mucoceles are benign cystic masses filled with mucous content. Mucoceles are locally destructive, causing pressure on sinus walls with their resorption, allowing them to spread on adjacent structures causing local, orbital or intracranial complications. They are most commonly found in frontal sinuses. The aim of this report is to present case of oculo-orbital complications of frontal sinus mucocele, with focus on treatment using combined surgical approach. A 75-year old female patient with frontal sinus mucocele which led to destruction of orbital roof and occurrence of complications in form of orbital cellulitis and palpebral abscess was successfully treated with a combination of external frontoethmoidectomy and endoscopic sinus surgery. After initial incision of the upper eyelid abscess with drainage of purulent content, modified external frontoethmoidectomy was performed using preformed defect of orbital roof. Finally, using endoscopic sinus surgery, natural drainage of anterior group of paranasal sinuses was achieved. Various endoscopic and open approaches have been described in mucocele treatment. In this case we showed that the combined surgical approach in the treatment of frontal sinus mucoceles with destruction of sinus floor and appearance of oculo-orbital complications, provides an effective treatment and allows natural drainage of anterior group of sinuses.

Laterally located mucocele in a hyperpneumatized frontal sinus causing exophthalmos: A total endoscopic approach

Frontal sinus mucoceles are mucous secretory lesions within the sinus, presenting a slow – growing pattern, mostly behaving like a space-occupying mass with subtle symptoms until a bone erosion of the surrounding structures takes place. Intracranial and intraorbital expansion are regarded as the most considerable complications, demanding adequate surgical management in order to avoid recurrence. Endoscopic drainage is thought to be the current treatment of choice, with external approaches or combined approaches being considered for more severe cases where anatomy and disease extension restricts adequate endoscopic visualization of the lesion. We present a case of a 31-year-old female patient with a left frontal sinus mucocele, demonstrating with an unusual lateral frontal expansion and orbit invasion, causing exophthalmos and ophthalmoplegia. She was adequately managed by a Draf III endoscopic procedure achieving wide marsupialization and enough drainage of the mucocele. No sign of recurrence was noticed during the last 6-month follow-up. Giant mucoceles of the frontal sinus are a rare pathology. To our knowledge, endoscopic endonasal approach is a treatment modality that can provide an adequate drainage pathway, thus resulting in optimal clinical outcomes, compared with external approaches. Keywords: Frontal sinus; Mucocele; Exophalmos; Pneumosinus dilatans; Pneumocele.

Intracerebral hemorrhage after endoscopic marsupialization of huge frontal sinus mucocele

Frontal Mucocele grows gradually and unnoticed as a benign lesion but, as the frontal mucocele expands to and compresses surrounding organs like brain, orbit, etc., it can cause diverse symptoms and signs.Although the surgical approaches of mucocele include open, endoscopic and combined approach, endoscopic marsupialization has been commonly used because endoscopic marsupialization was reported with high success rates, low complication rates and better operative vision. However, recently we experienced rare complication of endoscopic marsupialization of huge frontal mucocele, large amount of intracerebral hemorrhage, immediately after successful surgery and report this rare case with short review.

A Rare Case of Sphenoid Sinus Mucocele Presenting with Lateral Rectus Palsy.

The sphenoid sinus mucoceles are rare and have an incidence of 1%, when sufficiently large they can compress optic canal, superior orbital fissure and vital structures causing optic neuropathy, ptosis, ophthalmoplegia and diplopia. We herein report a 73year old male who presented with headache and left lateral rectus palsy secondary to sphenoid sinus mucocele which was confirmed on MRI and successfully treated with endoscopic marsupialization.

Acute Third Nerve Palsy with Pupillary Sparing: A Rare Manifestation of Sphenoid Sinus Mucocele

Mucocele of para-nasal sinus is a rare entity resulting from chronic accumulation of mucoid secretion, leading to progressive thinning of sinus bony wall. We are presenting a case report of a middle age female patient with sphenoid mucocele causing sudden third cranial nerve palsy with pupil sparing. She was managed by urgent endoscopic marsupialzation.

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

Mucopyocele: An Entity Infrequently Reported as a Complication of Functional Endoscopic Sinus Surgery.

Paranasal sinus mucocele or mucopyocele development after functional endoscopic sinus surgery is an infrequent phenomenon. The risk of mucocele development after endoscopic surgery for nasal polyposis or for chronic rhinosinusitis with nasal polyposis increases with greater preoperative Lund-Mackay score, with suboptimal post-operative management and with infrequent follow up post-surgery. We are reporting a case of bilateral fronto-ethmoidal mucocele developing secondary to FESS, its management and a brief literature review.

Paranasal sinus mucucele; linical presentations and surgical management

Mucoceles of the paranasal sinus are benign expandable lesions that primarily occur between the fourth and seventh decades of life. In this study, the cases diagnosed with paranasal sinus mucocele who were operated by a single surgeon between 2002 and 2019 were evaluated in terms of symptoms, surgical technique, complications, and recurrence and discussed in the light of the literature. In this study, we retrospectively analyzed 75 patients, 76 mucoceles who underwent operations due to paranasal sinus mucoceles between January 2002 and December 2019. In the patients diagnosed with a mucocele, the mucocele was removed surgically. Of the 75 patients, 36 were female and 40 were male. All the patients were between the ages of 21 and 85, with an average age of 56.9 years old. Mucocele formation occurred in the frontal sinus in 46 (61%) patients, the maxillary sinus in 16 (21%) patients the ethmoid sinus in 11 (14%) patients, and the sphenoid sinus in 3 (4%). 1 patient had both frontal and maxillary sinus mucocele. 15 underwent surgery using external approach. All patients were followed-up with endoscopic examinations for 13 months to 4 years. 4 of 76 mucoceles (5,3%) experienced recurrence Treatment of paranasal sinus mucoceles is surgical and usually simple drainage and marsupialization of mucoceles is sufficient. The endoscopic approach in the treatment of sphenoid, maxillary and ethmoid mucoceles is the surgical method of choice without question. However, in frontal sinus mucocele surgery, external surgery is still valid as much as endoscopic sinus surgery.

Optic Neuropathy Caused by an Ethmoid Sinus Mucocele Encasing the Optic Nerve.

Optic Neuropathy Caused by an Ethmoid Sinus Mucocele Encasing the Optic Nerve.