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Jadach R, Osypko K, Nelke K, Nowicki A. Croco Eye Technique: Mucous Retention Cyst Excision with Immediate Open Sinus Lift-A Retrospective Cohort Study. J Clin Med 2024; 13:3293. [PMID: 38893004 PMCID: PMC11172874 DOI: 10.3390/jcm13113293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/25/2024] [Accepted: 05/29/2024] [Indexed: 06/21/2024] Open
Abstract
Objectives: A mucous retention cyst is a common, asymptomatic lesion that may cause complications during or after the sinus lift procedure. The goal of this study is to assess the effectiveness of the Croco Eye Technique (CET), which allows simultaneous excision of the cyst and sinus floor elevation. Methods: The technique was thoroughly described in two versions, and the group of 33 patients was analyzed. Patients who qualified for this procedure had insufficient alveolar ridge height, and their CBCT showed radiological images typical for retention cysts. Analyzed parameters included the version of CET, demographic data, anatomical parameters, intraoperative complications, recurrence of the cyst, success rate of the sinus lift and implants, and the follow-up period. Results: Out of the 33 cases, 9 were of the primary version (27.27%) and 24 of the final version (72.73%). The average height of a retention cyst was 24.05 mm, with the average alveolar ridge height of 1.86 mm. In three cases (9.09%), implants were placed immediately. The prevalence of uncontrolled Schneiderian membrane perforation was reduced from 55.56% to 4.17% between the primary and final versions. The cyst's recurrence rate was 3.13%. The implant survival rate was 100%. The mean follow-up period was 48.625 months (max 110 months). Conclusions: The Croco Eye Technique, despite the perforation of the Schneiderian membrane, enables successful sinus lift and implantation with a success rate of 100%. Excision of the retention cyst, which is the cause of perforation, allows for limiting the risk of the cyst's recurrence.
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Affiliation(s)
- Radosław Jadach
- Private Practice, ul. E. Horbaczewskiego 53A, 54-130 Wrocław, Poland;
| | - Karolina Osypko
- Dental Salon, Oral Surgery Academy, ul. E. Horbaczewskiego 53A, 54-130 Wrocław, Poland
| | - Kamil Nelke
- Maxillo-Facial Surgery Ward, EMC Hospital, Pilczycka 144, 54-144 Wrocław, Poland;
| | - Adam Nowicki
- Diamante Clinica Dental Clinic, Sportowa 48 A/C, 59-300 Lubin, Poland;
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2
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Paksoy M, Keskin S, Erdoğan BA. The Relationship Between Destruction Sites and Clinical Findings in Diffuse Paranasal Sinus Mucoceles. Indian J Otolaryngol Head Neck Surg 2024; 76:2429-2436. [PMID: 38883479 PMCID: PMC11169430 DOI: 10.1007/s12070-024-04533-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/22/2024] [Indexed: 06/18/2024] Open
Abstract
Objective This study aimed to investigate that complicated mucoceles of paranasal sinuses and their clinical presentation, complications of relations with size, destructions areas, extension limits in affected patients. Materials and methods A retrospective review was performed on patients who were diagnosed and treated as paranasal sinus mucoceles at ENT department from 2002 to 2013 years. Patients' demographic data, mucoceles location, symptoms, surgical approach and complications were evaluated. Results The study group included 9 male and 10 female patients with a mean age of 45,0 years (range, 12-76 years). This case series include fronto-ethmoidal complex (52,6%), followed by frontal (26,3%), maxillary (15,7%) and sphenoid sinus mucoceles (5,2%). Endoscopic sinus surgery (ESS) was performed on 11 patients (57.8%); endoscopic procedures included marsupialization through an infundibulotomy, associated with an anterior ethmoidectomy and maxillary sinus antrostomy. Four patients (21%) underwent an external surgical procedure. 8 patients (42%) were treated by a combination of both endoscopic and external approaches such as trephination of the anterior wall of the frontal sinus, osteoplastic flap approach, Caldwell-Luc operation, anterior craniotomy and Lynch procedure. Complications occurred only in 2 cases (10.5%). Conclusion The majority of patients with extensive paranasal sinus mucoceles exhibited ophthalmologic and intracranial symptoms. A satisfactory outcome can be achieved after surgical treatment of both endoscopic and external approaches.
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Affiliation(s)
- Mustafa Paksoy
- Ear Nose Throat Clinic, VM Medicalpark Maltepe Hospital, Maltepe, Istanbul, Turkey
| | - Serhan Keskin
- Ear Nose Throat Clinic, Gebze Fatih State Hospital, Gebze, Kocaeli Turkey
| | - Banu Atalay Erdoğan
- Ear Nose Throat Clinic, Istinye University Faculty of Medicine, VM Medicalpark Pendik Hospital, Pendik, Istanbul, Turkey
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Meng X, Yue JI, Han C. Prelacrimal recess approach for multiseptated maxillary sinus mucocele involving the orbital and maxillary bone: A case report. Asian J Surg 2023; 46:5088-5089. [PMID: 37419813 DOI: 10.1016/j.asjsur.2023.06.090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 06/15/2023] [Indexed: 07/09/2023] Open
Affiliation(s)
- Xiangming Meng
- Department of Otolaryngology, Wuxi Huishan District People's Hospital, 2 Zhanqian North Road, Luoshe Town, Huishan District, Wuxi, 214187, PR China.
| | - JIng Yue
- Department of Otolaryngology, Wuxi Huishan District People's Hospital, 2 Zhanqian North Road, Luoshe Town, Huishan District, Wuxi, 214187, PR China
| | - Chengzhou Han
- Department of Otolaryngology, Wuxi Huishan District People's Hospital, 2 Zhanqian North Road, Luoshe Town, Huishan District, Wuxi, 214187, PR China
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Shi Q, Geng C, Wang M. Maxillary Sinus Mucocele With Fungal Ball. J Craniofac Surg 2023; 34:e759-e760. [PMID: 37594021 DOI: 10.1097/scs.0000000000009632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 06/05/2023] [Indexed: 08/19/2023] Open
Abstract
Mucocele is a benign, expansile, and oppressive lesion, more common in the frontal and ethmoid sinus and less in the maxillary sinus. Sinus mucocele mainly causes cheek swelling pain and nasal obstruction. In some cases, the paranasal mucocele grows large enough to compress periorbital structures and lead to impaired vision. Generally, mucocele is full of simple mucus, but pathogens can be found if co-infected, which means a poor prognosis. Functional endoscopic sinus surgery is an effective treatment for this disease. Here, the authors report a case that a mucocele occurred in the maxillary sinus, and a fungal ball was also found during the operation, which is a result of Paecilomyces farinosus co-infection.
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Affiliation(s)
- Qingyang Shi
- Department of Otorhinolaryngology, Head and Neck Surgery, Peking University People's Hospital, Beijing, China
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Shanbag RD, Pandurangi A, Dinesh R. Mucoceles of Paranasal Sinuses: A Single Centre Experience. Indian J Otolaryngol Head Neck Surg 2022; 74:1147-1152. [PMID: 36452573 PMCID: PMC9702458 DOI: 10.1007/s12070-020-02206-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/05/2020] [Indexed: 11/30/2022] Open
Abstract
Describe experience of managing paranasal sinus mucoceles, with either endoscopic endonasal approach (EESS) or combined external with EESS approach. Retrospective study done at SDMCMS&H, between 2007 and 2019, on patients undergoing surgical excision of mucocele. Results described as mean, median, mode, percentages. Twenty-one patients were included, with male to female ratio (0.75:1), mean age (42.95 years). Commonest presentation were facial pain (42.85%),visual symptoms (28.57%), headache (23.80%). Signs included, proptosis (52.38%), facial deformity (23.80%). Imaging: showed frontal mucoceles (42.85%), fronto-ethmoid (38.09%), ethmoid (14.28%), sphenoid (4.76%). Orbital extension in 42.85%, sinusitis (33.33%), skull base erosion (23.80%). EESS or combined external and EESS approach (61.90%, 38.09% respectively) were performed. Complete excision of mucocele wall done. Recurrence in two cases(average-2.5 years),revision surgery performed without further recurrences. Either EESS or combined external and EESS approach used based on site and extension of mucoceles. Complete peeling of mucocele wall without obliteration of the sinus cavity was the mode of surgical management in all cases.
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Affiliation(s)
- Raghunath D. Shanbag
- Department of Otorhinolaryngology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka India
| | - Aniketh Pandurangi
- Department of Otorhinolaryngology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka India
| | - Rashmi Dinesh
- Department of Otorhinolaryngology, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka India
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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.
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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
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Vlaminck L, Pollaris E, Vanderperren K, Tremaine WH, Raes E. Diagnosis and Surgical Treatment of Idiopathic Primary Sino-Nasal Obstruction in Miniature Horse Breeds: Long-Term Follow-Up of Seven Cases. Front Vet Sci 2021; 8:680150. [PMID: 34295933 PMCID: PMC8290127 DOI: 10.3389/fvets.2021.680150] [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: 03/13/2021] [Accepted: 06/01/2021] [Indexed: 11/13/2022] Open
Abstract
Idiopathic sino-nasal obstruction resulting in retention of large amounts of liquid in the paranasal sinus compartments was diagnosed in seven young (2. 2 ± 0.7 years) miniature-breed horses based on clinical, endoscopic, radiographic, and CT scan examinations. The most prevalent clinical signs included decreased or no airflow from the nostril(s) (7/7) and nasal discharge (6/7). The problem presented bilaterally in six of seven cases. An alternative sino-nasal communication was created through bone flap osteotomy surgery and perforation of the ventromedial floor of the dorsal conchae in all cases, followed by fixation of silicone irrigation tubes/Foley catheters in six of seven cases to keep the newly created ostium patent. This resulted in long-term resolution of the problem with good cosmetic appearance in all animals following a median period of 19 months. Premature loss of fixed tubes was reported in three cases.
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Affiliation(s)
- Lieven Vlaminck
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Elke Pollaris
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Katrien Vanderperren
- Department of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | - Els Raes
- Department of Medical Imaging of Domestic Animals and Orthopedics of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Makihara S, Kariya S, Okano M, Naito T, Tsumura M, Nishizaki K. Orbital complications of infected mucocele in the paranasal sinuses. Auris Nasus Larynx 2020; 47:990-995. [DOI: 10.1016/j.anl.2020.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 05/04/2020] [Accepted: 05/27/2020] [Indexed: 11/16/2022]
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Medikeri RS, Sinha KA. Sinus Floor Augmentation in Presence of Mucocele Eroding Maxillary Sinus Wall: A Case Report With 3 Years Follow-Up. Clin Adv Periodontics 2019; 10:81-87. [PMID: 31657529 DOI: 10.1002/cap.10083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 06/09/2019] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The maxillary mucocele is a slow-growing aggressive lesion and a mucous-containing sac lined with epithelium that occurs due to ductal obstruction and self-limiting injury. Rarely, it may be associated with non-specific symptoms. It is characterized by bone resorption due to its expanding behavior. Reduced height of bone and sinus pneumatization associated with pathologic lesions located in the floor of maxillary sinus may impede sinus augmentation. Therefore, careful diagnosis and management of pathology before sinus floor elevation is important in determining its recurrence and prognosis. CASE PRESENTATION We reported a case with small mucocele on right pneumatized antrum with insufficient residual bone height for implant placement. Radiograph in the region of teeth #3 and #4 revealed a homogeneous solitary radiopaque mass. Cone-beam computed tomography revealed irregular osteolysis of the lateral wall of the sinus. It was excised through Caldwell-Luc technique and simultaneous sinus augmentation was performed. Later, delayed implant restoration was performed. No complication or recurrence was reported during 36 months of follow-up. CONCLUSIONS The excision of mucocele on sinus floor and simultaneous sinus augmentation obviates the need for the extended treatment period. The clinician must be habituated with the anatomy and pathology of the maxillary sinus to evade any non-essential complications following lateral sinus floor augmentation procedure. A diminutive mucocele should not be regarded as a contraindication for sinus augmentation; sometimes it manifests with bone erosion. The prompt diagnosis and careful evaluation are needed to avoid future complications during implant therapy.
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Affiliation(s)
- Raghavendra S Medikeri
- Department of Periodontology, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
| | - Kumar Ankit Sinha
- Department of Periodontology, Sinhgad Dental College and Hospital, Pune, Maharashtra, India
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Transnasal inferior meatal antrostomy with a mucosal flap for post-Caldwell-Luc mucoceles in the maxillary sinus. The Journal of Laryngology & Otology 2019; 133:674-677. [PMID: 31378208 DOI: 10.1017/s0022215119001233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Transnasal inferior meatal antrostomy is increasingly used for the treatment of post-Caldwell-Luc mucoceles in maxillary sinus. This study aimed to report the outcomes after inferior meatal antrostomy with a mucosal flap for recurrent mucoceles. METHOD The records of patients who had undergone transnasal inferior meatal antrostomy with or without a mucosal flap were reviewed. RESULTS Transnasal endoscopic inferior meatal antrostomy with or without a mucosal flap was performed in 21 and 49 patients, respectively. No complications were observed. A closing of the antrostomy was found in 9 (18.4 per cent) of the 49 patients who underwent antrostomy without a mucosal flap. No closings were observed in the 21 patients who underwent antrostomy with a mucosal flap. There was a significant difference in the rate of closing for surgery with and without the mucosal flap. CONCLUSION Transnasal endoscopic inferior meatal antrostomy with a mucosal flap is a safe method for the treatment of post-Caldwell-Luc maxillary mucoceles that effectively prevents recurrence.
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Modified endoscopic inferior meatal fenestration with mucosal flap for maxillary sinus diseases. Wideochir Inne Tech Maloinwazyjne 2018; 13:533-538. [PMID: 30524626 PMCID: PMC6280079 DOI: 10.5114/wiitm.2018.77556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 05/10/2018] [Indexed: 11/24/2022] Open
Abstract
Introduction This is a novel minimally invasive surgical method for maxillary sinus mucoceles and antrochoanal polyps. Aim To describe a modified technique of inferior meatal fenestration with a mucosal flap for maxillary sinus diseases and to present a case series of subjects who underwent this procedure. The novel surgical technique and indications for this approach are also discussed. Material and methods The authors analyzed data from 32 cases involving patients who underwent resection of maxillary sinus mucoceles and antrochoanal polyps via modified endoscopic inferior meatal fenestration with a mucosal flap in the period from January, 2011 to January, 2016. The group included 19 men and 13 women, and the patients’ mean age was 36.2 years (range: 11–56 years). Preoperative and postoperative imaging studies were available in all cases and were reviewed. Results Thirty-two cases are included in this study. The appearance of nasal and (or) maxillary sinus mucosa was observed in the follow-up at 1 month, 3 months and 6 months using endoscopes. Postoperative computed tomography was performed for only 9 patients in this study. The mean follow-up period was 56 (range: 10–82) months in these cases. All patients had an uneventful post-operative period. Postoperative symptoms were relieved gradually for 1 to 2 weeks after the operation. No patients experienced recurrent symptoms related to the mucocele. Mucocele and polyps recurrence was not observed. No patient showed re-stenosis and obstruction of the nasal cavity, facial pain or numbness during follow-up. Conclusions Maxillary sinus mucoceles and antrochoanal polyps are completely excised via modified endoscopic inferior meatal fenestration with a mucosal flap. It could keep the nasal lateral wall intact.
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Albu S, Dutu AG. Concurrent middle and inferior meatus antrostomy for the treatment of maxillary mucoceles. Med Pharm Rep 2017; 90:392-395. [PMID: 29151786 PMCID: PMC5683827 DOI: 10.15386/cjmed-775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 05/09/2017] [Accepted: 05/10/2017] [Indexed: 11/25/2022] Open
Abstract
Background and aims This study describes the technique of simultaneous middle and inferior antrostomy and outlines its usefulness in the management of maxillary mucoceles. Methods This is a retrospective review of 12 consecutive patients with isolated maxillary mucocele operated on by means of middle and inferior antrostomy technique. We describe the clinical picture, details of the surgical technique and outcomes. Results There were 7 males and 5 females with ages ranging from 20 years to 65 years (mean 42 years). One patient had past trauma to the face and one had a long history of chronic sinusitis. Eight patients had undergone multiple previous sinus operative procedures including Caldwell-Luc approach. All patients underwent middle and inferior antrostomy without complications. Follow-up was between 12 months and 60 months (mean 36 months) with no recurrences to date. Conclusion In conclusion the results of our small series support the worth of using middle and inferior antrostomy when dealing with maxillary mucoceles.
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Affiliation(s)
- Silviu Albu
- 2nd Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alina Gabriela Dutu
- Department of Medical Biochemistry, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Maxillary sinus mucocele: predisposing factors, clinical presentations, and treatment. Oral Maxillofac Surg 2016; 21:55-58. [PMID: 27896530 DOI: 10.1007/s10006-016-0599-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 11/18/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE Maxillary sinus mucocele (MSM) is uncommon lesion and has many presenting features. The aim of this study was to detect the possible predisposing factors, clinical characteristics, and to assess the efficacy of trans-nasal endoscopic treatment of this lesion. METHODS This retrospective multicenter study was conducted on 36 patients with MSM, the diagnosis of the disease was based on computed tomographic criteria. The patients' history, presenting features, and surgical management were reviewed. All patients were followed up postoperatively for at least 3 years. RESULTS Chronic sinusitis, previous surgery, allergic rhinitis, and nasal trauma may be implicated as predisposing factors for the disease. However, in some patients (56%) the cause may remain uncertain. MSM may present with unilateral cheek pain, heaviness, swelling, numbness, hemifacial pain, nasal obstruction, nasal discharge, and/or proptosis. All patients were treated with trans-nasal endoscopic marsupialization through the middle meatus, patients with large MSM showed bulged medial maxillary wall, and they needed to empty the fluid through inferior antrostomy to facilitate introduction of the instruments to the middle meatus. All patients reported resolution of their symptoms, and none required revision surgery through the follow-up period. CONCLUSIONS MSM has several predisposing factors such as chronic sinusitis, previous surgery, allergic rhinitis and nasal trauma. However, some patients have no identifiable cause. The disease can present with a variety of symptoms which are usually related to their expansion and subsequent pressure on the surrounding structures. Trans-nasal endoscopic approach is an effective and safe method for treatment of the lesion.
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Menezes JDDSD, Moura LB, Pereira-Filho VA, Hochuli-Vieira E. Maxillary Sinus Mucocele as a Late Complication in Zygomatic-Orbital Complex Fracture. Craniomaxillofac Trauma Reconstr 2016; 9:342-344. [PMID: 27833714 DOI: 10.1055/s-0036-1582453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 11/22/2015] [Indexed: 10/21/2022] Open
Abstract
This article presents an unusual case of maxillary sinus mucocele as a late complication of zygomatic-orbital complex fracture, 23 years after the initial treatment. The patient was referring diplopia and decreased visual acuity with signs of dystopia, proptosis, and epiphora. Computed tomographic scan revealed an expansive lesion in the maxillary sinus with surrounding bone erosion and displacement of the eyeball. Treatment option was excisional biopsy and orbital floor reconstruction with titanium mesh restoring the appropriate orbital position. We propose that in the case of postoperative ophthalmological sequelae of facial fractures involving paranasal sinuses, mucocele should be considered in the differential diagnosis.
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Affiliation(s)
- Juliana Dreyer da Silva de Menezes
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, Dentistry School at Araraquara - Unesp, Araraquara-SP, Brazil
| | - Lucas Borin Moura
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, Dentistry School at Araraquara - Unesp, Araraquara-SP, Brazil
| | - Valfrido Antonio Pereira-Filho
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, Dentistry School at Araraquara - Unesp, Araraquara-SP, Brazil
| | - Eduardo Hochuli-Vieira
- Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, Dentistry School at Araraquara - Unesp, Araraquara-SP, Brazil
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15
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Clinical Analysis and Surgical Results of 58 Paranasal Sinus Mucoceles. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2015. [DOI: 10.1016/j.otoeng.2015.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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16
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Barrow EM, DelGaudio JM. In-office drainage of sinus Mucoceles: An alternative to operating-room drainage. Laryngoscope 2014; 125:1043-7. [DOI: 10.1002/lary.25042] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 08/25/2014] [Accepted: 09/09/2014] [Indexed: 11/09/2022]
Affiliation(s)
- Emily M. Barrow
- Department of Otolaryngology-Head and Neck Surgery; Emory University School of Medicine; Atlanta Georgia U.S.A
| | - John M. DelGaudio
- Department of Otolaryngology-Head and Neck Surgery; Emory University School of Medicine; Atlanta Georgia U.S.A
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17
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Martel-Martín M, Gras-Cabrerizo JR, Bothe-González C, Montserrat-Gili JR, De Juan-Delago M, Massegur-Solench H. [Clinical analysis and surgical results of 58 paranasal sinus mucoceles]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2014; 66:92-7. [PMID: 25128247 DOI: 10.1016/j.otorri.2014.06.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 05/27/2014] [Accepted: 06/04/2014] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Mucoceles are slow-growing, benign lesions found in the paranasal sinuses that are locally destructive, causing bony resorption an displacement of adjacent structures. We present our experience in the surgical treatment of these lesions. METHODS This was a retrospective review of 58 paranasal sinus mucoceles in 54 patients between 1989 and 2012. We describe patient age and sex, mucocele location, clinical features, surgical approaches employed, recurrence and complications. RESULTS The mean age of patients in this series was 59 years; there were 31 males (57%) and 23 females (43%). Thirty-two cases (55%) were located in the frontal or ethmoid-frontal system, 8 (14%) in the ethmoid sinus, 14 (24%) in the maxillary sinus and 4 (7%) in sphenoid sinus. Predisposing factors were present in 55% of the patients and 45% cases were primary. Endoscopic treatment was given to 71% of mucocele patients, while 29% were treated with external or combined approaches. Recurrence appeared in 4 patients (7%), 2 in the endoscopic surgery group and 2 in the external surgery group. CONCLUSIONS The procedure of choice for management of paranasal sinus mucoceles is endoscopic drainage. It is a safe approach that gives good results.
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Affiliation(s)
- María Martel-Martín
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Barcelona, España.
| | - Juan R Gras-Cabrerizo
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | | | - Joan R Montserrat-Gili
- Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
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Durr ML, Goldberg AN. Endoscopic partial medial maxillectomy with mucosal flap for maxillary sinus mucoceles. Am J Otolaryngol 2014; 35:115-9. [PMID: 24411137 DOI: 10.1016/j.amjoto.2013.10.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 10/27/2013] [Accepted: 10/28/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE To describe a technique of endoscopic medial maxillectomy with mucosal flap for postoperative maxillary sinus mucoceles and to present a case series of subjects who underwent this procedure. MATERIALS AND METHODS This case series includes four subjects with postoperative maxillary sinus mucoceles who underwent resection via endoscopic partial medial maxillectomy with a mucosal flap. We will discuss the clinical presentation, imaging characteristics, operative details, and outcomes. RESULTS Four subjects are included in this study. The average age at the time of medial maxillectomy was 52 years (range 35-65 years). Three subjects (75%) were female. One subject (25%) had bilateral postoperative maxillary sinus mucoceles. Two subjects (50%) had unilateral right sided mucoceles, and the remaining subject had a unilateral left sided mucocele. All subjects had a history of multiple sinus procedures for chronic sinusitis including Caldwell-Luc procedures ipsilateral to the postoperative mucocele. All subjects underwent endoscopic medial maxillectomy without complication and were symptom free at the last follow up appointment, average 24 months (range 3-71 months) after medial maxillectomy. CONCLUSIONS For postoperative maxillary sinus mucoceles in locations that are difficult to access via the middle meatus antrostomy, we recommend endoscopic medial maxillectomy with mucosal flap. Our preliminary experience with four subjects demonstrates complete resolution of symptoms after this procedure.
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Scangas GA, Gudis DA, Kennedy DW. The natural history and clinical characteristics of paranasal sinus mucoceles: a clinical review. Int Forum Allergy Rhinol 2013; 3:712-7. [PMID: 23696282 DOI: 10.1002/alr.21178] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 04/02/2013] [Indexed: 11/06/2022]
Abstract
BACKGROUND A retrospective data analysis at a university tertiary referral center was conducted to characterize the natural history, clinical characteristics, management principles, and outcomes of paranasal sinus mucoceles. METHODS A chart review was performed on 102 patients with a total of 133 paranasal sinus mucoceles who were treated between 1987 and 2011 at the Hospital of the University of Pennsylvania. RESULTS The study population included patients with a mean age of 53.1 years (range, 22-82 years). Patients were diagnosed with a mucocele on average 5.3 years following prior functional endoscopic sinus surgery (FESS), 17.7 years following prior paranasal sinus trauma, and 18.1 years following prior open sinus surgery. The most common presenting symptoms were headache (42.1%) and maxillofacial pressure (28.6%). The most common sites were the frontal, frontoethmoidal, and ethmoid sinuses. Fifty-seven mucoceles (44.9%) had intraorbital extension, intracranial extension, or both. Out of 133 mucoceles, 114 underwent ESS without complication. CONCLUSION The length of time between prior surgery or trauma and mucocele presentation highlights the importance of long-term follow-up in both patient care and in the understanding and reporting of surgical outcomes. In this study, most patients exhibited nonspecific symptomatology despite extensive mucoceles and a significant incidence of orbital and skull-base erosion. The endoscopic approach can be safely used for the management of such lesions.
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Affiliation(s)
- George A Scangas
- Department of Otorhinolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA
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Chronic rhinosinusitis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2013; 1:205-11; quiz 212-3. [PMID: 24565477 DOI: 10.1016/j.jaip.2012.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Revised: 11/29/2012] [Accepted: 12/03/2012] [Indexed: 11/22/2022]
Abstract
A 50-year-old woman with nonallergic rhinitis, asthma, and aspirin intolerance presented with worsening symptoms of nasal congestion, purulent drainage, and anosmia. Nasal polyps were visualized on anterior rhinoscopy, and there was evidence of chronic rhinosinusitis (CRS) on imaging studies during work-up for another medical condition. Over a 2-year period she had numerous bouts of acute exacerbations of CRS which required multiple courses of antibiotics; however, she was unwilling to undergo surgery to reduce polyp burden. She successfully underwent aspirin desensitization and experienced partial relief of symptoms with daily aspirin ingestion. Nasal obstruction is a common symptom that can result from multiple causes, including mucosal disorders (eg, allergic and nonallergic rhinitis, rhinosinusitis, sarcoid) and structural disorders (eg, nasal septal deviation, tumors, mucoceles). The various causes and work-up for nasal obstruction are discussed with emphasis placed on CRS, which is a prevalent disease characterized by inflammation of the nose and paranasal sinuses for a duration of >12 weeks. The different subtypes of CRS, including CRS with and without nasal polyps, allergic fungal rhinosinusitis, and aspirin-exacerbated respiratory disease, are discussed along with pathogenesis, diagnosis, and treatment options.
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Chahed H, Romdhane N, Zainine R, Abid W, Sahtout S, Besbes G. [Pediatric mucoceles: clinical aspects and therapeutic approaches]. ACTA ACUST UNITED AC 2012; 113:437-41. [PMID: 22818665 DOI: 10.1016/j.stomax.2012.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2011] [Revised: 02/13/2012] [Accepted: 05/04/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Paranasal sinuses mucoceles are extremely rare in children and adolescents. The objective of this study was to assess their clinical presentations and the contribution of endoscopic surgery in their management. MATERIAL AND METHODS we retrospectively reviewed 11 children with paranasal sinus mucoceles who were managed during a period of 15 years (1995-2009). RESULTS The mean age was 11.8 years with a sex ratio of 2.66. One patient had a history of nasal polyposis surgery. The symptomatology was dominated by ophthalmological complains. The ethmoïd sinus was the main localization. Orbital extension was found in eight cases, pyomucocele in one case. The surgical management was endoscopic (nine cases), and by an external approach (two cases). Two cases of recurrence were assessed. The mean follow-up was 22.3 months. DISCUSSION Paranasal sinuses mucocele is exceptional in children. Cystic fibrosis is the main etiologic factor. The symptoms depend on the location and size of the mucocele. The treatment is surgical and most authors prefer the endoscopic approach.
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Affiliation(s)
- H Chahed
- Service ORL et chirurgie maxillo-faciale de la Rabta, CHU La Rabta, 1007 Bab-Saadoun, Tunis, Tunisie.
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Tuli IP, Pal I, Chakraborty S, Sengupta S. Persistent deciduous molar as an etiology for a maxillary sinus mucocele. Indian J Otolaryngol Head Neck Surg 2012; 63:6-8. [PMID: 22754822 DOI: 10.1007/s12070-011-0168-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2008] [Accepted: 08/10/2008] [Indexed: 11/28/2022] Open
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 persistent carious deciduous molar in a middle aged patient, reported to highlight its unusual etiology.
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Affiliation(s)
- Isha Preet Tuli
- Department of ENT & HNS, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim India
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Nazar R, Naser A, Pardo J, Fulla J, Rodríguez-Jorge J, Delano PH. Manejo endoscópico de mucoceles de senos paranasales: experiencia en 46 pacientes. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2011; 62:363-6. [DOI: 10.1016/j.otorri.2011.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 04/18/2011] [Accepted: 04/20/2011] [Indexed: 11/17/2022]
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Nazar R, Naser A, Pardo J, Fulla J, Rodríguez-Jorge J, Delano PH. Endoscopic Management of Paranasal Sinus Mucoceles: Experience With 46 Patients. ACTA ACUST UNITED AC 2011. [DOI: 10.1016/j.otoeng.2011.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Transnasal endoscopic marsupialization of postoperative maxillary mucoceles: middle meatal antrostomy versus inferior meatal antrostomy. Eur Arch Otorhinolaryngol 2011; 268:1583-7. [PMID: 21607579 DOI: 10.1007/s00405-011-1636-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Accepted: 05/10/2011] [Indexed: 10/18/2022]
Abstract
The aim of this study was to evaluate the efficacy of transnasal endoscopic marsupialization as a treatment modality in patients with postoperative maxillary mucoceles and to compare the efficacy of marsupialization via middle meatal antrostomy with that of marsupialization via inferior meatal antrostomy. The study design was a retrospective clinical series and the setting was a tertiary referral center. After obtaining approval from the local ethics committee, we reviewed the medical records of 39 consecutive patients with postoperative maxillary mucoceles who were diagnosed and treated at the Department of Otolaryngology, Chang Gung Memorial Hospital, Taiwan, from 2004 to 2009. Transnasal endoscopic marsupialization was performed on 32 patients (34 sides) with postoperative maxillary mucoceles. All patients were followed for more than 12 months after surgery, and recurrence was noted in five patients (14.9%). Recurrence was experienced by five patients who underwent inferior meatal antrostomy and zero patients who underwent middle meatal antrostomy; thus, a statistically significant difference (p = 0.04) was observed. Transnasal endoscopic marsupialization is an effective modality for postoperative maxillary mucoceles and results in reduced morbidity. The use of middle meatal antrostomy in particular is preferred.
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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.
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Affiliation(s)
- José Marques
- School of Dentistry, University of Barcelona, Barcelona, Spain
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Abstract
PURPOSE Paranasal 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 METHODS We 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. RESULTS The 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. CONCLUSION The 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.
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Affiliation(s)
- Kyung Chul Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 78 Saemunan-gil, Jongno-gu, Seoul 110-746, Korea.
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Obeso S, Llorente JL, Pablo Rodrigo J, Sánchez R, Mancebo G, Suárez C. [Paranasal sinuses mucoceles. Our experience in 72 patients]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2009; 60:332-9. [PMID: 19814985 DOI: 10.1016/j.otorri.2009.05.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2009] [Accepted: 05/05/2009] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Traditional treatment for paranasal sinuses mucoceles recommended total removal through external approaches. Since the 90s, endoscopic marsupialization has been proposed as optimal surgical treatment. We present our experience in the treatment of this pathology. MATERIAL AND METHOD A retrospective review of 72 patients treated for paranasal sinuses mucoceles between 1980 and 2006 in our ENT department was performed. We describe clinical features, surgical approaches employed and recurrence of disease. RESULTS The sample was composed of 72 patients with average follow-up period of 44 months (range 13-214 months). A total of 81 mucoceles were presented, with 44% affecting the frontal sinus or frontoethmoidal cells, followed in frequency by maxillary sinus mucoceles (35%). Twenty-nine percent of the patients did not present predisposing factors; 31% of patients had a history of nasal polyposis, 35% had undergone previous sinus surgery and 14% suffered previous facial fractures; 48 mucoceles patients were treated endoscopically and 33 were treated with external or combined approaches. Recurrence was found in 7 patients, 2 in the endoscopic surgery group and 5 in the external/combined surgery group. CONCLUSIONS Endoscopic marsupialization is a safe approach with a low rate of recurrence. The endoscopic approach may be unsuitable for frontal lateral sinus mucoceles or those with significant bone blockage.
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Affiliation(s)
- Sergio Obeso
- Hospital Universitario Central de Asturias, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Asturias, España
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Obeso S, Luis Llorente J, Pablo Rodrigo J, Sánchez R, Mancebo G, Suárez C. Paranasal sinuses mucoceles. Our experience in 72 patients. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2009. [DOI: 10.1016/s2173-5735(09)70153-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Gosau M, Rink D, Driemel O, Draenert FG. Maxillary sinus anatomy: a cadaveric study with clinical implications. Anat Rec (Hoboken) 2009; 292:352-4. [PMID: 19248167 DOI: 10.1002/ar.20859] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study measured maxillary sinus volume, evaluated the location of the semilunar hiatus in correlation to the nasal floor, and the incidence, location, and height of antral septa and discusses their clinical implications. Maxillary sinus volume was quantified in 65 cadavers (130 sinuses) by water application through the semilunar hiatus and measuring the used amount. The location of the semilunar hiatus was identified as distance from the nasal floor. The septa were counted, evaluated, and the size measured from the antral floor. The medium maxillary sinus volume was 12.5 mL (range, 5-22 mL). The medium location of the semilunar hiatus was 25.6 mm above the nasal floor (range, 18-35 mm). Thirty-five septa were counted in 130 maxillary sinuses. This equals an incidence of 27%. The medium height of the septa was 5.4 mm (2.5-11 mm). The main location of the septa was the region of the first molar (29%), the second molar (23%), and the second premolar (23%). The height, location, and number of septa as well as the height of the semilunar hiatus and volume of the maxillary sinus have to be taken into consideration to correctly plan the procedure and amount of grafting material in maxillary sinus floor elevation operations.
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Affiliation(s)
- M Gosau
- Department of Cranio-Maxillo-Facial Surgery, University of Regensburg, Josef-Strauss-Allee 11, Regensburg, Germany.
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Endoscopic middle meatal antrostomy in treatment of maxillary sinus mucoceles. VOJNOSANIT PREGL 2009; 66:207-11. [PMID: 19341226 DOI: 10.2298/vsp0903207p] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIM Mucocele of a paranasal sinus is a benign non-neoplastic condition characterized by cystic expansion and distension of the sinus cavity by retained mucoid secretions. Etiology is unknown. The purpose of this study was to estimate the efficiency of the endoscopic middle meatal antrostomy (MMA) as a treatment modality in patients with maxillary sinus mucoceles. METHODS This retrospective study involved 11 patients with maxillary sinus mucoceles/pyoceles treated endoscopically in the Clinic for Otorhinolaryngology of Military Medical Academy, Belgrade over a 3-year period (2005-2007). The presented symptoms and signs, radiological and pathohistological findings and surgical treatment were reviewed. RESULTS There were four females and seven males, age 22 to 65 years (mean 33 years). Two patients were with allergic rhinitis. All the patients complained of nasal obstruction, ten had facial pain, seven had nasal discharge, five had cheek pressure, and four had epiphora, and four had headaches. On endoscopic nasal examination, the medial wall of the maxillary sinus was bulging in ten patients. Purulent drainage was seen in eight patients, septal deviation in ten, and polyps were found in two of the patients. The MMA and marsupialization of the mucocele were performed in all the patients. On histopathological examination, the mucocele wall showed a lining composed of respiratory epithelium. Postoperative follow-up ranged between 8 and 44 months (in six patients, it ranged from 24 to 44 months). No patients required revision surgery. CONCLUSION The MMA with mucocele marsupialization abolishes middle meatal obstruction and establishes better drainage and ventilation of the maxillary sinus and restitution of its mucosa.
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