1
|
Naik D, Aten K, Lopez D, Patel J. A Real Headache: Intracranial Extension and Epidural Abscess As Complication of Chronic Mucocele. Cureus 2023; 15:e49875. [PMID: 38170035 PMCID: PMC10760984 DOI: 10.7759/cureus.49875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 01/05/2024] Open
Abstract
Mucoceles are benign lesions of salivary glands typically originating from the paranasal sinuses. Intracranial extension and superinfection of these lesions are rare but serious complications of chronic mucoceles. Here, we discuss a patient with a known mucocele, initially lost to follow-up, who presented three years later with headache, purulent rhinorrhea, and intracranial extension of his mucocele with development of an epidural abscess. This case highlights the potential complications of chronic, large mucoceles and emphasizes the importance of thorough evaluation in patients with facial abscesses in the setting of known sinus pathology. Any mucocele with signs of superinfection such as purulent rhinorrhea, abscess near the sinuses, or refractory symptoms should warrant cranial imaging. Mucoceles with evidence of intracranial extension require neurosurgical and/or otolaryngologic evaluation for evacuation and debridement to avoid neurologic injury or devastating infection.
Collapse
Affiliation(s)
- Divya Naik
- Internal Medicine, Methodist Health System, Dallas, USA
| | | | - Dylan Lopez
- Internal Medicine, Methodist Health System, Dallas, USA
| | - Jaimin Patel
- Internal Medicine, Methodist Health System, Dallas, USA
| |
Collapse
|
2
|
Aburas S, Schneider B, Pfaffeneder-Mantai F, Meller O, Balensiefer A, Turhani D. Long-term persistent discomfort due to a giant frontoethmoidal osteoma despite complete surgical removal - A case report. Ann Med Surg (Lond) 2022; 78:103814. [PMID: 35734687 PMCID: PMC9206933 DOI: 10.1016/j.amsu.2022.103814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/12/2022] [Accepted: 05/14/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Giant frontoethmoidal osteomas are rare, slow-growing, benign osseous tumours, frequently causing severe life impairing symptoms due to their proximity to noble structures. Initially, osteomas are often diagnosed on radiographs by chance. Their aetiology can be considered ambiguous. They may either be treated by active observation, medical therapy, radio and thermal therapy, or surgery. Case presentation We report the case of a 56-year-old female patient with a giant osteoma spreading from the nasal cavity to the entire frontoethmoidal sinus, leading to headaches, respiratory problems, and nausea for several years. For a period of 20 years, a watch and wait approach was applied. Finally, the osteoma was removed using a combined open and endoscopic approach. One year after the operation, a secondary mucocele developed, accompanying headaches and facial pressure due to its continuous expansion. Despite numerous consultations, she refused surgical intervention until today. Discussion Early detection and removal of frontoethmoidal osteomas improves the prognosis for a favourable treatment outcome. The smaller the osteoma, the easier it can be removed endoscopically. The decision to perform surgery was made when the condition drastically affected the patient's quality of life. To date, there is still no strong consent regarding the best surgical approach and the best time to do it. Conclusion The combination of open and endoscopic surgery remains a safe and straightforward procedure for the removal of giant frontoethmoidal osteomas. Early detection and intervention are crucial for a predictable minimally invasive treatment with a favourable outcome for the patient. Early removal of frontoethmoidal osteomas improves the prognosis for a favourable minimally invasive treatment outcome. The smaller the osteoma, the easier it can be removed exclusively by endoscopy. The combination of open and endoscopic surgery remains a safe and uncomplicated procedure for the removal of giant frontoethmoidal osteomas.
Collapse
Affiliation(s)
- Sarmad Aburas
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria
| | - Benedikt Schneider
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria
| | - Florian Pfaffeneder-Mantai
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria
- Division for Chemistry and Physics of Materials, Department of Medicine, Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria
| | - Oliver Meller
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria
| | - Arne Balensiefer
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria
| | - Dritan Turhani
- Center for Oral and Maxillofacial Surgery, Department of Dentistry, Faculty of Medicine and Dentistry, Danube Private University, Steiner Landstraße 124, 3500, Krems, Austria
- Corresponding author. Center for Oral and Maxillofacial Surgery, Danube Private University(DPU), Steiner Landstraße 124, 3500, Krems, Austria.
| |
Collapse
|
3
|
Yeom HG, Lee W, Han SI, Lee JH, Lee BD. Mucocele in the maxillary sinus involving the orbit: A report of 2 cases. Imaging Sci Dent 2022; 52:327-332. [PMID: 36238698 PMCID: PMC9530297 DOI: 10.5624/isd.20210278] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 04/28/2022] [Accepted: 05/02/2022] [Indexed: 11/18/2022] Open
Abstract
Mucocele of the paranasal sinuses is a benign, slow-growing, expansile lesion. Maxillary sinus mucoceles are usually associated with painless bulging of the cheek; however, orbital expansion is rarely observed. Maxillary sinus mucoceles can be classified as primary or secondary according to their etiology. An impediment to sinus ostium ventilation is thought to be the cause of primary mucocele, while sequestering of residual mucosa after surgery in the wound and long-term retention of tissue fluid have been suggested to lead to the formation of secondary mucocele. This report presents 2 cases of primary and secondary mucoceles, with a focus on radiographic features. As primary and superiorly positioned secondary maxillary sinus mucoceles are uncommon and their close proximity to the orbit predisposes the patient to significant morbidity, the authors expect that this report will contribute to a better understanding and diagnosis of maxillary sinus mucocele involving the orbit.
Collapse
Affiliation(s)
- Han-Gyeol Yeom
- Department of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan, Korea
| | - Wan Lee
- Department of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan, Korea
| | - Su-Il Han
- Department of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan, Korea
| | - Jae-Hoon Lee
- Department of Otolaryngology, Institute of Wonkwang Medical Science, School of Medicine, Wonkwang University, Iksan, Korea
| | - Byung-Do Lee
- Department of Oral and Maxillofacial Radiology and Wonkwang Dental Research Institute, College of Dentistry, Wonkwang University, Iksan, Korea
| |
Collapse
|
4
|
Dalil AB, Siafa AB, Nkouo YCA, Biouele RCM, Ngom EGM, Fogha JVF, Mvondo CM, Njock LR. [Aberrant internal carotid artery: a rare cause of cough: about a clinical case]. Pan Afr Med J 2021; 39:219. [PMID: 34630831 PMCID: PMC8486930 DOI: 10.11604/pamj.2021.39.219.30266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 07/10/2021] [Indexed: 11/11/2022] Open
Abstract
Aberrant course of the internal carotid artery is a rare congenital malformation. Aberrant course of cervical internal carotid artery accounts for 5% of cases. Several cases of fatal hemorrhage due to an injury to the aberrant internal carotid artery have been observed in patients undergoing pharyngeal surgery procedures. This was associated with a lack of detection during surgery. Ear nose and throat (ENT) practitioner need to know it. We here report a case of aberrant internal carotid manifesting as chronic cough due to the contact of the epiglottis with the pharyngeal mass caused by the aberrant artery. The patient was treated for chronic lung disease without success. This particular anatomical condition should be suspected in patients with pharyngeal mass before any invasive procedure.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Charles Mve Mvondo
- Faculté de Médecine et des Sciences Pharmaceutiques de Douala, Douala, Cameroun
| | - Louis Richard Njock
- Faculté de Médecine et des Sciences Pharmaceutiques de Douala, Douala, Cameroun
| |
Collapse
|
5
|
Ali S, Qasim A, Anwar B, Choudhary N, Akmal M. Intradural extension of mucocele secondary to giant frontal sinus osteoma: Diagnostic pitfalls. Surg Neurol Int 2021; 12:252. [PMID: 34221583 PMCID: PMC8247709 DOI: 10.25259/sni_11_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/08/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Paranasal sinus osteoma in association with intracranial mucocele is a rare entity while intradural extension is even rarer. Our aim of presenting this case is to highlight the diagnostic pitfalls and reiterate the importance of prompt treatment of expected complications. Case Description: A 35-year-old known epileptic, for the past 5 years, presented with altered sensorium for the past 2 days. Computed tomography (CT) of the brain plain showed ventriculomegaly and cystic lesion in the left frontal lobe adjacent to a calvarial osteoma. A ventriculoperitoneal (VP) shunt was done which resulted in tension pneumocephalus and led us to discover the origin of osteoma from the left frontal sinus on CT functional endoscopic sinus surgery (FESS) protocol. He underwent left frontal craniotomy. The osteoma and mucocele were excised completely and watertight primary dural closure was done. Postoperative meningitis was treated with antibiotics according to the culture report. Conclusion: Intracranial extension of mucocele led to meningitic hydrocephalus, prompting us for VP shunt. Resulting tension pneumocephalus revealed what was missed on preop CT, a small pocket of air adjacent to osteoma intracranially. Therefore, this case underscores the importance of obtaining a preoperative CT FESS to elaborate the origin of osteoma, thus planning approach differently.
Collapse
Affiliation(s)
- Sundus Ali
- Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Adnan Qasim
- Department of Neurosurgery, King Edward Medical University, Mayo Hospital, Lahore, Punjab, Pakistan
| | - Bilal Anwar
- Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore General Hospital, Lahore, Punjab, Pakistan
| | - Nabeel Choudhary
- Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore General Hospital, Lahore, Punjab, Pakistan
| | - Muhammad Akmal
- Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore General Hospital, Lahore, Punjab, Pakistan
| |
Collapse
|
6
|
Dempsey KS, Tooley AA, Patel PJ, Charles NC, Belinsky I. Orbital and Eyelid Inflammation With "Muciphages" and Extravasated Mucin From an Ethmoido-orbital Mucocele. Ophthalmic Plast Reconstr Surg 2021; 37:e1-e3. [PMID: 32332688 DOI: 10.1097/iop.0000000000001685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 22-year-old woman presented with an acute compressive optic neuropathy due to a ruptured ethmoido-orbital mucocele. She underwent urgent orbital decompression and drainage of the mucocele via an endoscopic approach. Postoperatively, her course was complicated by an orbital compartment syndrome supervened, exhibiting severe eyelid edema caused by infiltration with mucin and mucin-containing macrophages ("muciphages"). Biopsy of the eyelid showed infiltration with "muciphages," macrophages laden with extravasated mucinous material. This is the first report that documents the clinical and histopathologic course of orbital inflammation following mucocele extravasation into the orbit and eyelids.
Collapse
Affiliation(s)
| | | | | | - Norman C Charles
- Department of Ophthalmology.,Department of Pathology, New York University Langone Medical Center, New York, New York, U.S.A
| | | |
Collapse
|
7
|
Abducens Nerve Paralysis Induced by a Primary Solitary Sphenoid Sinus Mucocele with Broad Osseous Thinning at the Cranial Base. Case Rep Otolaryngol 2020; 2020:8897868. [PMID: 33282425 PMCID: PMC7686843 DOI: 10.1155/2020/8897868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/16/2020] [Accepted: 09/22/2020] [Indexed: 11/17/2022] Open
Abstract
Primary solitary sphenoid sinus mucocele is rare, generally presenting with headaches or eye symptoms at the anatomical site. We report the case of a 39-year-old woman incidentally diagnosed with sphenoid sinus mucocele during a complete medical checkup. Imaging revealed that the cystic wall had developed from the rear sphenoid sinus and had spread expansively to diminish the clivus; however, no symptoms were reported, and the patient was managed with close observation. During the follow-up period, diplopia developed suddenly due to isolated left-sided abducens nerve paralysis. An endoscopic endonasal approach was used to open the frontal cystic wall, and fascia lata and fat were used for cranial base reinforcement to avoid future cerebrospinal fluid leakage, resulting in improvement during the early stages of follow-up. Treatment options for sphenoid sinus mucoceles include close observation or surgery. In our case, we chose surgery because of an acute symptomatic manifestation during observation.
Collapse
|
8
|
Cossu G, Daniel RT, Francois P, Destrieux C, Messerer M. Sphenoid Mucocele with Intracranial Extension: An Anatomic Perspective. World Neurosurg 2018; 113:40-46. [PMID: 29438786 DOI: 10.1016/j.wneu.2018.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Revised: 02/01/2018] [Accepted: 02/02/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Isolated sphenoid mucoceles are rare, but because of their close proximity to important vasculonervous structures, local extension may result in serious consequences. CASE DESCRIPTION A 47-year-old patient presented with headaches, meningismus, and a left homonymous lateral hemianopia. We report the atypical evolution of a posttraumatic sphenoid mucocele invading the sellar region and extending into the subarachnoid space with compression of the right optic tract, and we describe its surgical management. Further, with the aid of cadaveric specimens, we aim to analyze the precise pathway followed by the expanding collection from an anatomic perspective. CONCLUSIONS Anatomic knowledge of the sellar and parasellar regions is the key to understand the process of how sphenoid mucoceles may extend intracranially. Early endoscopic drainage with a large sphenoidotomy allows favorable outcomes and prevents serious consequences.
Collapse
Affiliation(s)
- Giulia Cossu
- Department of Neurosurgery, University Hospital of Lausanne, Lausanne, Switzerland; Department of Neurosurgery, CHRU de Tours, Tours, France.
| | - Roy T Daniel
- Department of Neurosurgery, University Hospital of Lausanne, Lausanne, Switzerland
| | | | - Christophe Destrieux
- Department of Neurosurgery, CHRU de Tours, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Mahmoud Messerer
- Department of Neurosurgery, University Hospital of Lausanne, Lausanne, Switzerland
| |
Collapse
|
9
|
Lee JT, Brunworth J, Garg R, Shibuya T, Keschner DB, Vanefsky M, Lin T, Choi S, Stea R, Thompson LDR. Intracranial mucocele formation in the context of longstanding chronic rhinosinusitis: A clinicopathologic series and literature review. ALLERGY & RHINOLOGY 2014; 4:e166-75. [PMID: 24498523 PMCID: PMC3911807 DOI: 10.2500/ar.2013.4.0064] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Chronic rhinosinusitis (CRS) can lead to serious long-term adverse sequelae, particularly if left untreated. The aim of this study was to describe a series of intracranial mucoceles (ICMs) that arose in the context of longstanding CRS combined with a review of the pertinent literature. A retrospective chart review was performed on all patients who developed ICMs in association with CRS between 2003 and 2012. The clinical presentation, radiographic features, surgical approach, intraoperative findings, and patient outcome were examined in the context of a literature review. Sixty-five cases of mucoceles were identified in patients with a history of CRS, of which seven (10.8%) were intracranial. Five patients were men and two were women with a mean age of 42.1 years. Headache, facial pressure, retro-orbital pain, and visual disturbances were the most common presenting symptoms. Five of the seven had previously undergone sinonasal surgery. Imaging studies showed ICMs involving the anterior cranial fossa, two of which were bilateral. Latency between onset of CRS and ICM detection ranged from 3 to 19 years (mean, 9.4 years). All patients underwent endoscopic transnasal drainage with three also requiring a concurrent, open neurosurgical procedure to access the intracranial component. There were no postoperative complications, and no recurrences were observed after a mean follow-up of 2.7 years. ICMs presenting as delayed complications of CRS are uncommon and constitute a surgical challenge. Open, external skull base approaches used in conjunction with transnasal endoscopic drainage procedures may be necessary to achieve successful management of this rare condition.
Collapse
Affiliation(s)
- Jivianne T Lee
- Orange County Sinus Institute, Southern California Permanente Medical Group, Irvine, California, ; Department of Head and Neck Surgery, David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California
| | - Joseph Brunworth
- Orange County Sinus Institute, Southern California Permanente Medical Group, Irvine, California
| | - Rohit Garg
- Orange County Sinus Institute, Southern California Permanente Medical Group, Irvine, California
| | - Terry Shibuya
- Orange County Sinus Institute, Southern California Permanente Medical Group, Irvine, California
| | - David B Keschner
- Orange County Sinus Institute, Southern California Permanente Medical Group, Irvine, California
| | - Marc Vanefsky
- Department of Neurosurgery, Anaheim Medical Center, Southern California Permanente Medical Group, Anaheim, California
| | - Tina Lin
- Department of Neurosurgery, Anaheim Medical Center, Southern California Permanente Medical Group, Anaheim, California
| | - Soohoo Choi
- Department of Neurosurgery, Anaheim Medical Center, Southern California Permanente Medical Group, Anaheim, California
| | - Richard Stea
- Department of Neurosurgery, Anaheim Medical Center, Southern California Permanente Medical Group, Anaheim, California
| | - Lester D R Thompson
- Department of Pathology, Woodland Hills Medical Center, Southern California Permanente Medical Group, Woodland Hills, California
| |
Collapse
|
10
|
Giant frontal mucocele complicated by subdural empyema: treatment of a rare association. Acta Neurol Belg 2012; 112:85-90. [PMID: 22427297 DOI: 10.1007/s13760-012-0030-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Accepted: 04/28/2011] [Indexed: 10/14/2022]
Abstract
Giant frontal mucocele (GFM) is an extremely rare cause of frontal lobe syndrome. Subdural empyema (SDE) is an uncommon complication of paranasal sinisutis, for which craniotomy and decompressive craniotomy are the most effective surgical procedures. A 54-year-old man was brought unconscious to the emergency room where recurrent generalized seizures occurred. Heroine abuse, HCV-related hepatitis, prolonged antibiotic therapy for treatment of purulent rhinorrhea, along with recent personality changes were reported. High white blood cell count, pansinusitis, GFM, SDE and cerebritis were documented. The patient underwent bifrontal craniotomy in emergency, extensive drilling of the inner aspect of the frontal bone, surgical toilet of the enlarged frontal sinus and its "cranialization". Prevotella intermedia and Fusobacterium nucleatum were isolated and antibiotic therapy was started intravenously and then continued orally for 3 months. 2 years later the patient has recovered, though minor signs of frontal lobe syndrome persist. To the authors knowledge, this is the first case of GFM with SDE reported in the literature. Although decompressive craniectomy is advocated in extreme conditions, as in this case, "internal decompressive craniectomy", obtained with craniotomy and cranialization of the frontal sinuses, is strongly advocated in cases of SDE associated with megasinuses.
Collapse
|
11
|
A Case of Petrous Apex Mucocele with Unilateral Ear Fullness Treated with Endoscopic Sphenoid Marsupialization. ACTA ACUST UNITED AC 2012. [DOI: 10.3342/kjorl-hns.2012.55.7.453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
12
|
Kim YS, Kim K, Lee JG, Yoon JH, Kim CH. Paranasal sinus mucoceles with ophthalmologic manifestations: a 17-year review of 96 cases. Am J Rhinol Allergy 2011; 25:272-5. [PMID: 21819766 DOI: 10.2500/ajra.2011.25.3624] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The purpose of this study was to assess the characteristics of paranasal sinus mucoceles with ophthalmologic manifestations with a focus on optic neuropathy. METHODS From January 1993 to May 2010, 96 consecutive patients diagnosed with paranasal sinus mucoceles with ophthalmologic manifestations were investigated. Clinical and therapeutic factors and demographics were reviewed from medical records. Statistical associations between clinical and therapeutic factors and visual outcomes after surgery were also analyzed. RESULTS A total of 352 patients were diagnosed with paranasal sinus mucoceles and underwent surgical treatment. Ninety-six of them presented with ophthalmologic symptoms, and periorbital swelling and pain were the most common symptoms (36.4%) in those patients. Among the 96 patients with ophthalmologic manifestations, 18 (18.8%) were diagnosed with optic neuropathy based on the deterioration of their visual acuity and unilateral relative afferent papillary defect. Ten of these 18 patients showed improvements in their vision after surgical intervention. The statistical analysis of the association between clinical and therapeutic factors and visual outcomes showed that the presence of infection was the only significant factor (p = 0.023). CONCLUSION Paranasal sinus mucoceles present various ophthalmologic manifestations. Among them, optic neuropathy may be one of the most devastating conditions. In treating optic neuropathy caused by mucoceles, the presence of infection was the only factor that had any influence on postoperative visual outcomes. Therefore, we conclude that not only surgical drainage and ventilation of the sinus are necessary, but infection control is also a vital factor in treating mucoceles with optic neuropathy.
Collapse
Affiliation(s)
- Yoo-Suk Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | | | | | | | | |
Collapse
|
13
|
Marques J, Figueiredo R, Aguirre-Urizar JM, Berini-Aytés L, Gay-Escoda C. Root resorption caused by a maxillary sinus mucocele: a case report. ACTA ACUST UNITED AC 2011; 111:e37-40. [PMID: 21444223 DOI: 10.1016/j.tripleo.2010.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 12/15/2010] [Indexed: 10/18/2022]
Abstract
A maxillary sinus mucocele is an infrequent but benign lesion that develops from the obstruction of a seromucous glandular duct of the maxillary sinus mucosa. This clinical entity is generally asymptomatic and self-limited. Mucoceles are described as rounded dome-shaped soft tissue masses frequently located on the floor of the maxillary sinus. In this paper, we present a case of a slightly radiopaque well defined shadow arising from the left maxillary sinus floor that produced the root resorption of the upper second left molar. After the surgical removal of the lesion through a Caldwell-Luc approach, histologic study confirmed the initial diagnosis of mucocele. This case report emphasizes the need of clinical and radiologic follow-up to detect any complications associated with these benign lesions, because, in rare occasions, they can show an aggressive growth pattern.
Collapse
Affiliation(s)
- José Marques
- School of Dentistry, University of Barcelona, Barcelona, Spain
| | | | | | | | | |
Collapse
|
14
|
Gurel K, Sanal S, Gurel S, Kalfaoglu M, Boran C. Two maxillary lesions containing bony/calcified shells. Dentomaxillofac Radiol 2009; 38:296-300. [PMID: 19474258 DOI: 10.1259/dmfr/33360963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Because of the close anatomical relationship between the maxillary sinus and the adjacent dental region, determining the primary site of cysts in these regions can be a diagnostic dilemma. In this article, two cases with similar radiological findings are presented. These cases had lesions involving the maxillary sinus and the adjacent alveolar process; the lesions were surrounded with egg-shaped, linear opacities. Diagnoses of a residual radicular cyst in one case and a calcified mucocoele (which is very rare) in the other case were predicted with the help of radiological findings and were confirmed surgically and histopathologically.
Collapse
Affiliation(s)
- K Gurel
- Department of Radiology, Izzet Baysal School of Medicine, Abant Izzet Baysal University, Bolu, Turkey.
| | | | | | | | | |
Collapse
|
15
|
Abstract
Radiologists face the daily challenge of analyzing and interpreting a high volume of images in a timely manner. Minimizing errors, whether perceptual or cognitive in nature, is paramount for high-quality diagnostics and patient care. There are certain areas within the head encountered at routine brain imaging in which the interpreting radiologist is most prone to make perceptual errors. These areas, or "blind spots," include the cerebral sulci, dural sinuses, orbits, cavernous sinuses, clivus, Meckel cave, brainstem, skull base, and parapharyngeal soft tissues. In addition, the use of an inappropriate window width and level for the evaluation of computed tomographic (CT) scans can be a virtual, rather than an anatomic, blind spot. The inclusion of a comprehensive checklist for evaluation of these blind spots as part of every brain imaging study is crucial for avoiding false-negative results. Knowledge of the anatomic features of these blind spots is also crucial, as well as familiarity with the normal CT and magnetic resonance imaging findings in these areas. In addition, the radiologist should be aware of possible interpretation pitfalls that may lead to false-positive results (eg, normal anatomic variants that may be mistaken for pathologic conditions). Finally, a well-developed differential diagnosis will help ensure correct interpretation and appropriate patient treatment.
Collapse
Affiliation(s)
- Simin Bahrami
- Department of Radiological Sciences, Ronald Reagan UCLA Medical Center, 1st Floor, Los Angeles, CA 90095-7437, USA.
| | | |
Collapse
|
16
|
Extensive paranasal sinus mucoceles: a 15-year review of 82 cases. Am J Otolaryngol 2009; 30:234-8. [PMID: 19563933 DOI: 10.1016/j.amjoto.2008.06.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2008] [Revised: 05/17/2008] [Accepted: 06/05/2008] [Indexed: 11/21/2022]
Abstract
PURPOSE The aim of the study was to report the clinical characteristics, management, and outcome of patients with extensive paranasal sinus mucoceles. MATERIALS AND METHODS In a retrospective study, 82 patients with intracranial or intraorbital extension due to paranasal sinus mucoceles who were surgically treated between 1993 and 2007 were studied. In addition, clinical data, presenting symptoms, clinical features, management, and outcome were analyzed. RESULTS The study population included 42 males and 40 females, with a mean age of 52.7 years (range, 15-87 years). The most common presenting symptoms were ptosis (27/82, 32.9%) and periorbital swelling (24/82, 29.3%). The main radiologic finding on computed tomography scan was bony defect of lamina papyracea and/or medial superior orbital rim. Sixty-six patients underwent endoscopic sinus surgery; among them, 3 patients had recurrence (3/77, 3.9%) during follow-up periods. CONCLUSION In our study, a majority of patients with extensive paranasal sinus mucoceles exhibited ophthalmologic symptoms before treatment (81/82, 98.8%). Computed tomography scanning was a feasible tool for preoperative assessment. A satisfactory outcome can be achieved after surgical treatment of endoscopic sinus surgery.
Collapse
|
17
|
Annear MJ, Gemensky-Metzler AJ, Elce YA, Stone SG. Exophthalmus secondary to a sinonasal cyst in a horse. J Am Vet Med Assoc 2008; 233:285-8. [DOI: 10.2460/javma.233.2.285] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|