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Bozovičar M, Božič M. Severe facial pain and removal of maxillary sinus mucous retention cyst. BMJ Case Rep 2024; 17:e259924. [PMID: 38684353 DOI: 10.1136/bcr-2024-259924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
Maxillary sinus retention cysts (MRCs) are typically asymptomatic and require no treatment. An early 30s man presented with a decade-long history of severe left-sided chronic facial pain (CFP). Multiple prior treatments resulted in an edentulous patient with persistent pain. Imaging revealed a dome-shaped radiopaque change in the left maxillary sinus. History and clinical examination suggested persistent idiopathic facial pain, and doubts about the outcome of a surgical intervention were explained to the patient. Surgical removal of the MRC via lateral antrotomy led to complete symptom resolution of CFP. This case substantiates the importance of considering MRCs as a possible cause of CFP. It also emphasises the need for a systematic multidisciplinary approach in cases of unexplained CFP.
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Affiliation(s)
- Matija Bozovičar
- Dentist, MB2 zobozdravstvena dejavnost, Matija Bozovičar s.p, Škofja Loka, Slovenia
| | - Marko Božič
- Surgery, OMF kirurgija Marko Božič, s.p, Celje, Slovenia
- Medicinska fakulteta, Univerza v Mariboru, Maribor, Slovenia
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2
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Chandora A, Kahn AG, Zamora K. Mucocele-like Lesions: Radiologic-Pathologic Correlation. J Breast Imaging 2024; 6:175-182. [PMID: 38394371 DOI: 10.1093/jbi/wbae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Indexed: 02/25/2024]
Abstract
Mucocele-like lesions (MLLs) of the breast are rare lesions described as dilated, mucin-filled cysts associated with rupture and extracellular mucin in the surrounding stroma. These lesions are of clinical concern because they can coexist with a spectrum of atypical and malignant findings, including atypical ductal hyperplasia, ductal carcinoma in situ, and invasive carcinoma including mucinous carcinoma. Imaging findings of MLLs are nonspecific and varied, although the most common initial finding is that of incidental coarse heterogeneous calcifications on mammography. Occasionally, an asymmetry or mass may be found with or without calcifications, and such MLLs have a higher rate of upgrade to malignancy at excision. Pathology findings are often descriptive given the small sample received from percutaneous biopsy, and the primary consideration is to report any associated atypia, including atypical ductal hyperplasia. There is consensus in the literature that MLLs with atypia on biopsy should undergo excision because of the average reported 17.5% (20/114) upgrade rate to malignancy. The upgrade rate for MLLs without atypia averages 4.1% (14/341). Therefore, imaging surveillance may be a reasonable alternative to excision for MLLs with no atypia on a case-by-case basis. We review MLL imaging findings, pathology findings, and clinical management and present 3 cases from our institution to add to the literature on these rare lesions.
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Affiliation(s)
- Agni Chandora
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Andrea G Kahn
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kathryn Zamora
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
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3
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Almoguera González FJ, Muñoz Casares C, González de Pedro C, Galán Villamor L, Padillo Ruiz FJ. Malakoplakia of the appendix as a rare differential diagnosis of mucocele: a case report. Cir Esp 2024; 102:174. [PMID: 37730119 DOI: 10.1016/j.cireng.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 03/27/2023] [Indexed: 09/22/2023]
Affiliation(s)
| | - Cristóbal Muñoz Casares
- Unidad de Gestión Clínica Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Carlos González de Pedro
- Unidad de Gestión Clínica Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Lourdes Galán Villamor
- Unidad de Gestión Clínica Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - Francisco Javier Padillo Ruiz
- Unidad de Gestión Clínica Cirugía General y del Aparato Digestivo, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Kearsey CC, Dritsas S, Mathur M, Wild J. 'It's just a mucocele': a case report of a massive appendiceal mucocele presenting as a left upper quadrant mass. Ann R Coll Surg Engl 2024; 106:93-95. [PMID: 36622245 PMCID: PMC10757871 DOI: 10.1308/rcsann.2022.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2022] [Indexed: 01/10/2023] Open
Abstract
Tumours of the appendix are very rare tumours that can and often present with a mucocele. This is a case report highlighting the associated pathology of appendix tumours and the management of a large mucocele. Specifically, how a right hemicolectomy is very rarely needed in these cases regardless of size and local anatomical relationships and some important considerations for the practicing surgeon in the non-tertiary centre that encounters a case like this.
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Affiliation(s)
- CC Kearsey
- The Christie NHS Foundation Trust, UK
- Institute of Translational Medicine, University of Liverpool, UK
| | - S Dritsas
- The Christie NHS Foundation Trust, UK
| | - M Mathur
- The Christie NHS Foundation Trust, UK
| | - J Wild
- The Christie NHS Foundation Trust, UK
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5
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Yoshida H, Kihara C, Satoh C, Kumai Y. CT analysis of predictors for visual acuity in optic neuropathy with mucocele. Auris Nasus Larynx 2023; 50:895-903. [PMID: 36967263 DOI: 10.1016/j.anl.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 02/15/2023] [Accepted: 03/10/2023] [Indexed: 04/03/2023]
Abstract
OBJECTIVE To evaluate the causative and risk factors for optic neuropathy with mucocele via imaging studies. METHODS We included 21 patients with rhinogenous optic neuropathy with mucocele. We collected data on the sinus involved, age, sex, number of days from the onset of visual impairment to surgery, and computed tomography (CT) imaging findings (bone defects in the lamina papyracea, Onodi cell mucocele, exophthalmos, and optic nerve deviation). The results were compared between two groups, the one having nine patients with pre-operative visual acuity of <0.1 (the poor group) and the other having 12 patients with pre-operative visual acuity of ≥0.1 (the fair group). Whether or not there was a difference in pre-operative visual acuity between patients with and without Onodi cell mucocele was determined. RESULTS After surgery, visual acuity improved in 16/21 (76.2%) patients, and a correlation analysis showed a significant positive correlation between pre-operative and post-operative visual acuity. In imaging, the causative sinuses accounted for 85.7% of both posterior ethmoid and sphenoid sinuses. Bone defects of the lamina papyracea at the optic canal and the vertical downward deviation of the optic nerve at each location, especially in 6/9 patients with Onodi cell mucocele, were characteristic in the poor group. In these conditions, increasing the contact areas of the optic nerve and mucocele can leads to more chances of direct downward compression of the optic nerve and infection occurring, and it may lead to severe pre-operative visual impairment. CONCLUSION Imaging studies of optic neuropathy with mucocele help to determine the risk factors and perform early and precise diagnostic imaging and decision-making for surgery.
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Affiliation(s)
- Haruo Yoshida
- Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Chiharu Kihara
- Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Chisei Satoh
- Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoshihiko Kumai
- Department of Otolaryngology-Head and Neck Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Hara H, Shimizu S, Muto Y, Kido T, Miyata R. Laparoscopic resection for appendiceal mucocele secondary to endometriosis: A case report. Medicine (Baltimore) 2023; 102:e36277. [PMID: 38013331 PMCID: PMC10681557 DOI: 10.1097/md.0000000000036277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/02/2023] [Indexed: 11/29/2023] Open
Abstract
INTRODUCTION This case report describes a patient who underwent laparoscopic resection of the mucocele of the appendix secondary to endometriosis, a rarity in clinical practice. PATIENT CONCERNS The patient was a 38-year-old woman with a history of endometriosis and an ovarian cyst who sought medical advice with a chief complaint of mild right lower abdominal pain. DIAGNOSES Computed tomography and ultrasonography of the abdomen revealed a cystic lesion at the distal end of the appendix without definitive findings of malignancy. Colonoscopy revealed a submucosal tumor-like elevation at the appendiceal orifice. Appendiceal mucocele was suspected preoperatively. INTERVENTIONS The lesion was resected laparoscopically. Secondary ileocecal resection with lymphadenectomy was possible if the resected specimen was pathologically diagnosed as a malignant tumor with the risk of lymph node metastasis. OUTCOMES The resected specimen was pathologically diagnosed as an appendiceal mucocele secondary to endometriosis; therefore, additional surgery was avoided. CONCLUSION Although appendiceal mucoceles secondary to endometriosis are rare, laparoscopic surgery in which only the lesion was resected is a useful strategy for the treatment and pathological diagnosis of appendiceal mucoceles without findings of malignancy.
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Affiliation(s)
- Hitoshi Hara
- Department of Surgery, Social Welfare Organization Saiseikai Imperial Gift Foundation Inc., Saiseikai Kazo Hospital, Kazo, Saitama, Japan
| | - Seito Shimizu
- Department of Surgery, Social Welfare Organization Saiseikai Imperial Gift Foundation Inc., Saiseikai Kazo Hospital, Kazo, Saitama, Japan
| | - Yasuhide Muto
- Department of Surgery, Social Welfare Organization Saiseikai Imperial Gift Foundation Inc., Saiseikai Kazo Hospital, Kazo, Saitama, Japan
| | - Tomoki Kido
- Department of Surgery, Social Welfare Organization Saiseikai Imperial Gift Foundation Inc., Saiseikai Kazo Hospital, Kazo, Saitama, Japan
| | - Ryohei Miyata
- Department of Surgery, Social Welfare Organization Saiseikai Imperial Gift Foundation Inc., Saiseikai Kazo Hospital, Kazo, Saitama, Japan
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Baeza M, Young BD, LaQuaglia KA, Rollins A, Aboellail TA. Computed tomographic imaging of a maxillary sinus mucocele in an 8-year-old French Bulldog. Vet Radiol Ultrasound 2023; 64:E73-E77. [PMID: 37667996 DOI: 10.1111/vru.13297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/19/2023] [Accepted: 08/15/2023] [Indexed: 09/06/2023] Open
Abstract
An 8-year-old male neutered French Bulldog was referred for continued nasal dyspnea following a staphylectomy revision performed one month prior to presentation. The patient had a prior history of skin allergies and underwent brachycephalic airway surgery performed at one year of age. Computed tomography (CT) revealed an osseous-encased, cystic mass arising from the right maxillary sinus. Surgical biopsies were performed and a mucocele with sinusitis and glandular hyperplasia was diagnosed. Based on our systematic review of the literature, maxillary sinus mucocele has not been reported in the dog and should be among the differentials for sinus cystic masses.
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Affiliation(s)
- Mercedes Baeza
- VCA Alameda East Veterinary Hospital, Denver, Colorado, USA
| | | | | | - Amanda Rollins
- VCA Alameda East Veterinary Hospital, Denver, Colorado, USA
| | - Tawfik A Aboellail
- Department of Microbiology, Immunology and Pathology, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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9
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Lee J, Choi YJ, Rha EY. Orbital Reconstruction Using a Polyetheretherketone Patient-Specific Implant After Removal of a Mucocele Developing After Orbital Fracture Repair. J Craniofac Surg 2023; 34:2321-2322. [PMID: 37603895 PMCID: PMC10597417 DOI: 10.1097/scs.0000000000009636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 08/23/2023] Open
Abstract
A few mucoceles developing secondary to facial bone fractures have been reported. Mucocele formation is thought to be attributable to displacement of the respiratory mucosa with obstruction of the sinus opening, especially if untreated. Accurate diagnosis and management are required; a growing mucocele will gradually destroy adjacent bony structures and cause irreversible complications. The authors describe a patient who presented with diplopia and mild discomfort when gazing upward. She had undergone reconstruction of medial and inferior orbital fractures 20 years previously. The patient was diagnosed with a mucocele developing after orbital fracture repair. The patient underwent mucocele removal and orbital reconstruction using a polyetheretherketone patient-specific implant. In a patient with orbital symptoms but without acute trauma, a mucocele should be among the differential diagnoses if history-taking reveals past orbital trauma and surgery. A polyetheretherketone patient-specific implant was effective for orbital reconstruction after mucocele removal.
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Affiliation(s)
- Junho Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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10
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Abstract
Primary clival mucoceles are a rare clinical entity that usually represents an incidental finding on computed tomography or magnetic resonance imaging scanning. There are only a few reports in the literature of patients who presented with vague symptoms such as headaches, facial paresthesia, and numbness. Clival mucoceles can also be secondary, by extension of a sphenoid mucocele to the clivus. We present a case of primary clival mucocele, aiming to highlight the importance of a multidisciplinary approach.
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Affiliation(s)
- Marios Stavrakas
- ENT Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Hisham S Khalil
- ENT Department, Derriford Hospital, University Hospitals Plymouth NHS Trust, Plymouth, UK
| | - Nikolaos Tsetsos
- Department of Otorhinolaryngology, Head and Neck Surgery, "G. Papanikolaou" General Hospital, Thessaloniki, Greece
| | - Samiul Muquit
- South West Neurosurgery Unit, Derriford Hospital, Plymouth, UK
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Zabeirou A, Efared B, James Didier L, Younssa H, Adama S, Moussa Y, Rachid S. Appendiceal mucocele as an exceptional cause of ileocecocolic intussusception in adults: a case report. J Med Case Rep 2023; 17:392. [PMID: 37710264 PMCID: PMC10503163 DOI: 10.1186/s13256-023-04133-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/17/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Intussusception is a rare condition in adults, accounting for 5% of intestinal intussusception and being responsible for approximately 1% of all adult bowel obstructions. Neoplastic origin is the most common etiology of intestinal intussusception in adults, unlike pediatric intussusception, which is usually idiopathic. Intussusception due to the appendiceal mucocele is exceptional, and only a few cases have been reported in the medical literature. CASE PRESENTATION We report the case of a 25-year-old black African male patient with no medical history. He presented to the emergency department for abdominal pain, nausea, and bilious vomiting. The abdominal examination revealed typical signs of acute bowel obstruction. Enhanced abdominopelvic computed tomography showed an invagination of the last ileal loop, cecum, and ascending colon into the lumen of the transverse colon, with a rounded image with hypodense content and some calcifications compatible with an appendiceal mucocele. An emergency exploratory laparoscopy was performed and confirmed the ileocecocolic intussusception. Right hemicolectomy and ileocolic anastomosis were performed. The patient recovery postoperatively was uneventful, and he was discharged 4 days later. Histological examination of the surgical specimen confirmed the diagnosis of mucinous cystadenoma. CONCLUSION The symptoms of bowel intussusception with the appendiceal mucocele as the lead point in adults are similar to any other bowel intussusception. Differential diagnosis is often carried out thanks to the injected abdominal computed tomography scan.
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Affiliation(s)
- Aliou Zabeirou
- Department of General and Visceral Surgery, Hôpital Général de Référence, Niamey, Niger.
| | - Boubacar Efared
- Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
| | - Lassey James Didier
- Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
| | - Hama Younssa
- Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
| | - Saidou Adama
- Department of General and Visceral Surgery, Hôpital Général de Référence, Niamey, Niger
- Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
| | - Younoussa Moussa
- Department of General and Visceral Surgery, Hôpital Général de Référence, Niamey, Niger
| | - Sani Rachid
- Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
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Wakeford W, Ioannidis D. Nasal obstruction in a 14 year old girl caused by a huge middle turbinate mucocele appearing radiologically as an inverted papilloma. J Radiol Case Rep 2023; 17:29-33. [PMID: 38098962 PMCID: PMC10718309 DOI: 10.3941/jrcr.v17i8.4774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2023] Open
Abstract
Introduction We present a case of a fourteen year old girl who presented with a large intra-nasal mass to the ENT team at a district general hospital in the UK. Presentation of case The girl presented predominantly with nasal obstruction and some symptoms of allergic rhinitis. Imaging revealed a large lesion abutting the skull base and causing bony remodelling with marked septal deviation. Based both on CT and MRI imaging, the reporting (non-head and neck) radiologist suggested inverted papilloma as a differential diagnosis. Intra-operative exploration in fact revealed a very large left middle turbinate mucocele extending to the left frontal sinus. The mass was excised endoscopically without complications. Discussion Although concha bullosa of the middle turbinate of the nose are common, development of a mucocele within them is far less common and for such a mucocele to develop to this size in a child is extremely rare. The egg shell lining of the lesion can be a tell-tale sign of their aetiology when taken alongside other radiological factors. This case highlights challenges in radiological diagnosis of intra-nasal masses in children, which can lead to delays and increased anxiety. Conclusion When assessing nasal masses in children it is important to keep a wide differential due to the challenges of diagnosis. A close conversation should be had with local head and neck radiologists and, of course, where there is a unilateral nasal mass tissue sampling is essential and may be taken as part of a full excision where clinically indicated.
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Affiliation(s)
- William Wakeford
- ENT Specialty Registrar, ENT Department, Colchester Hospital, East and North Essex NHS Foundation Trust, Colchester, UK
| | - Dimitrios Ioannidis
- Consultant ENT Surgeon, ENT Department, Colchester Hospital, East and North Essex NHS Foundation Trust, Colchester, UK
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13
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Valdec S, Stadlinger B. Mucocoele of the lower lip. CMAJ 2023; 195:E1125. [PMID: 37640402 PMCID: PMC10462414 DOI: 10.1503/cmaj.230466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Affiliation(s)
- Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, Zurich, Switzerland
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14
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Cevher S, Elkıran SA. Unusual ocular manifestations of ethomoidal mucocele: a case report. Arq Bras Oftalmol 2022; 87:0313. [PMID: 36169435 DOI: 10.5935/0004-2749.2021-0313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 04/14/2022] [Indexed: 12/18/2023] Open
Abstract
A 42-year-old female patient had vision loss and chronic epiphora in her left eye. Her best-corrected visual acuity was 10/10 in the right eye and 0.3/10 in the left eye. The anterior segment examination results were normal. In fundus examination, choroidal folds were detected. Optical coherence tomography showed elevation on the macula and choroidal folds. Ultrasonography revealed a T-sign. Magnetic resonance imaging revealed an ethmoidal mucocele that compresses the orbital tissues. Surgical treatment was performed in the otorhinolaryngology department. Postoperatively, choroidal folds recovered, and the best-corrected visual acuity improved, but subretinal fluid accumulated. During the follow-up period without any treatment, subretinal fluid totally disappeared.
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Affiliation(s)
- Selim Cevher
- Hitit University Faculty of Medicine, Department of Ophthalmology, Corum, Turkey
| | - Serdar Ali Elkıran
- Hitit University Erol Olçok Training and Research Hospital, Department of Otolaryngology, Corum, Turkey
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15
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Válek V, Bartušek D, Svoboda M, Válek V, Procházka V. Appendiceal mucocele - a radiologists view. Rozhl Chir 2021; 100:266-270. [PMID: 34465115 DOI: 10.33699/pis.2021.100.6.266-270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Appendiceal mucocele is an obstructive dilatation of the appendix, which results from the filling of its lumen with mucus. This is a rare condition that is asymptomatic in half of the patients. Its severity depends on the cause of appendiceal dilatation. In a small percentage of cases, the dilated appendix ruptures, leading to the development of serious complication; this is termed as pseudomyxoma peritonei. Due to the possibility of malignant etiology of the mucocele, surgical resection remains an essential part of the treatment.
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Bola AS, Andjock YCN, Choffor EN, Nanci E, Esene IN, Djomou F. Bilateral sphenoid sinus mucocele observed in Yaoundé-Cameroon: a case report. Pan Afr Med J 2021; 39:198. [PMID: 34603579 PMCID: PMC8464203 DOI: 10.11604/pamj.2021.39.198.22886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/05/2020] [Indexed: 11/14/2022] Open
Abstract
A mucocele is a cystic and expansive lesion of the sinus cavities. It is uncommon in the sphenoid sinus and its management is quite challenging especially in low to middle income countries like Cameroon. A 43-years-old female was referred to us by a neurologist for chronic headache and visual disturbances. The pain was unresponsive to analgesics. Physical examination was non-remarkable and a head CT scan realized showed a cyst-like lesion in the sphenoid sinus cavity. Surgical endoscopic treatment was proposed and realized with basic endoscopic instruments, consisting of opening the cavity with drainage of the mucocele. A large opening was made on the anterior wall of the sphenoid sinus, in order to ensure continuous drainage and prevent a recurrence. Sphenoid sinus mucocele is a rare condition, and its diagnosis can be difficult. Confirmation requires specific imaging and treatment is presently well established, but it can be managed with basic tools.
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Affiliation(s)
- Antoine Siafa Bola
- Department of Ophthalmology-Otolaryngology-Stomatology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Yves Christian Nkouo Andjock
- Department of Ophthalmology-Otolaryngology-Stomatology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | | | - Eliane Nanci
- Department of Ophthalmology-Otolaryngology-Stomatology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Ignatius Ngene Esene
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
| | - Francois Djomou
- Department of Ophthalmology-Otolaryngology-Stomatology, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
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Pérez-Sayáns M, Suárez Peñaranda JM, Quintanilla JAS, Chamorro Petronacci CM, García AG, Carrión AB, Vila PG, Sánchez YG. Clinicopathological features of 214 maxillary sinus pathologies. A ten-year single-centre retrospective clinical study. Head Face Med 2020; 16:24. [PMID: 33050926 PMCID: PMC7552481 DOI: 10.1186/s13005-020-00239-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 10/01/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diagnosis of maxillary sinus pathology must include the clinical radiological study (CRS) and histopathological analysis. The aim of this study is 1) to describe the clinicopathological features of maxillary sinus lesions, obtained successively in a single medical centre over the last 10 years and 2) to determine the sensitivity and specificity for the diagnosis of malignant lesions based exclusively on the CRS. METHODS It is a single-centre observational retrospective clinical study on patients who attended the University Hospital Complex of Santiago de Compostela (CHUS) with sinus pathologies during the period of 2009-2019. RESULTS The sample consisted of 133 men (62.1%) and 81 women (37.9%), with an average age of 46.9 years (SD = 18.8). In terms of frequency, the most frequent pathology was the unspecified sinusitis (44.4%), followed by polyps (18.2%), malignant tumours (9.8%), inverting papilloma (7.5%), fungal sinusitis (4.7%), cysts (3.7%), benign tumours (2.3%), mucocele (2.3%) and other lesions (1.9%). Cysts and benign tumours were diagnosed earliest Vs malignant tumours (65.2 years (SD = 16.1)) were diagnosed the latest (p < 0.001). Based only on the CRS for malignancies, diagnostic indexes were 71.4% sensitivity and 97.9% specificity, with a Kappa value of 0.68 with (p < 0.001). CONCLUSION Maxillary sinus pathology is very varied with therapeutic and prognostic repercussions. CRS is sometimes insufficient and histopathological confirmation is essential.
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Affiliation(s)
- Mario Pérez-Sayáns
- Health Research Institute of Santiago (IDIS), Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, C.P. 15782, Santiago de Compostela, Spain.
| | - José M Suárez Peñaranda
- Pathological Anatomy Service, University Hospital Complex of Santiago (CHUS), C.P. 15782, Santiago de Compostela, Spain
| | - Juan Antonio Suárez Quintanilla
- Area of Human Anatomy and Embryology, Faculty of Medicine and Dentistry, University of Santiago de Compostela, C.P. 15782, Santiago de Compostela, Spain
| | - Cintia M Chamorro Petronacci
- Health Research Institute of Santiago (IDIS), Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, C.P. 15782, Santiago de Compostela, Spain
| | - Abel García García
- Health Research Institute of Santiago (IDIS), Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, C.P. 15782, Santiago de Compostela, Spain
| | - Andrés Blanco Carrión
- Health Research Institute of Santiago (IDIS), Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, C.P. 15782, Santiago de Compostela, Spain
| | - Pilar Gándara Vila
- Health Research Institute of Santiago (IDIS), Oral Medicine, Oral Surgery and Implantology Unit (MedOralRes), Faculty of Medicine and Dentistry, University of Santiago de Compostela, C.P. 15782, Santiago de Compostela, Spain
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Ashrafi R, Turner M. Pulmonary barotrauma: assessment and investigation in divers. Undersea Hyperb Med 2019; 46:189-196. [PMID: 31051064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Decompression illness (DCI) is an uncommon problem but can be significant in terms of morbidity and, very rarely, mortality. The mechanisms of DCI are pulmonary barotrauma and decompression sickness due to inert gas supersaturation. After the initial management phase, identification of predisposing factors is important to help advise divers regarding future risk and avoidance. Here we present four cases of DCI where pulmonary barotrauma was the likely causative mechanism. We highlight the important features in assessment for pulmonary barotrauma and advising divers on the risk of a recurrence.
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Affiliation(s)
- Reza Ashrafi
- North West Congenital Heart Disease Partnership, Liverpool Heart and Chest Hospital, Liverpool UK
| | - Mark Turner
- Bristol Congenital Cardiac Centre, Bristol Royal Infirmary, Bristol UK
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Virgilio BA, Pontrelli G, Trevisan P, Sacchi D, Bernardini T, Scioscia M. Incidental diagnosis on transvaginal ultrasound of appendiceal mucocele arising on low-grade appendiceal mucinous neoplasm. Ultrasound Obstet Gynecol 2019; 54:412-414. [PMID: 30353587 DOI: 10.1002/uog.20158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 10/13/2018] [Accepted: 10/15/2018] [Indexed: 06/08/2023]
Affiliation(s)
- B A Virgilio
- Department of Obstetrics and Gynecology, Policlinico of Abano Terme, Abano Terme, Padua, Italy
| | - G Pontrelli
- Department of Obstetrics and Gynecology, Policlinico of Abano Terme, Abano Terme, Padua, Italy
| | - P Trevisan
- Department of Surgery, Policlinico of Abano Terme, Abano Terme, Padua, Italy
| | - D Sacchi
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padova, Padua, Italy
| | - T Bernardini
- Department of Obstetrics and Gynecology, Policlinico of Abano Terme, Abano Terme, Padua, Italy
| | - M Scioscia
- Department of Obstetrics and Gynecology, Policlinico of Abano Terme, Abano Terme, Padua, Italy
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Solinas L, Sagnotta A, Chessa A, Fiorini A, Battaglia B, Di Cosimo C, Notarangelo MG, Hassan R, Leone L, Mancini S. Pseudomixoma peritonei associated with appendiceal cistoadenoma rupture: case report. G Chir 2019; 40:213-216. [PMID: 31484011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Appendiceal mucocele represents specimen finding in 0.2-0.3% out of appendectomies. The rupture or perforation in peritoneal cavity might cause pseudomixoma peritonei (PMP), with multiple mucinous deposits in the abdominal cavity. We report a case of PMP caused by a perforated appendiceal cistoadeonoma.
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Ion D, Serban MB, Păduraru DN, Nica AE, Rahim AM, Andronic O. Appendiceal Mass - Dilemmas Regarding Extension of the Resection. Chirurgia (Bucur) 2019; 114:126-130. [PMID: 30830855 DOI: 10.21614/chirurgia.114.1.126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2019] [Indexed: 11/23/2022]
Abstract
Starting from a typical case, we try to highlight the main critical elements, both in the diagnostic algorithm and in the therapeutic one. We hereby present a 54-year old patient, known with hepatic steatosis and renal microlithiasis, which undergoes an ultrasonography in ambulatory, on the background of unsystematised abdominal discomfort; the ultrasound reveals the presence of a tumoral mass in the right iliac fossa.
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Aydın Y, Gedikli Y, Ogul H. Unusual Cause of Aerial Trapping; Bronchial Atresia. Arch Bronconeumol 2019; 55:590. [PMID: 30606630 DOI: 10.1016/j.arbres.2018.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 11/22/2018] [Accepted: 11/23/2018] [Indexed: 11/18/2022]
Affiliation(s)
- Yener Aydın
- Department of Thoracic Surgery, Medical Faculty, Ataturk University, Erzurum, Turkey
| | - Yusuf Gedikli
- Division of Radiology, Bayburt State Hospital, Bayburt, Turkey
| | - Hayri Ogul
- Department of Radiology, Medical Faculty, Ataturk University, Erzurum, Turkey.
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Clavijo González CN, Larrañaga N, Espil G, Dos Ramos Alferes JP, Kozima S. [Brain abscess as a complication of frontal mucocele]. Medicina (B Aires) 2019; 79:235. [PMID: 31284262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Affiliation(s)
- Carol N Clavijo González
- Servicio de Diagnóstico por Imágenes, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina. E-mail:
| | - Nebil Larrañaga
- Servicio de Diagnóstico por Imágenes, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina
| | - German Espil
- Servicio de Diagnóstico por Imágenes, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina
| | | | - Shigeru Kozima
- Servicio de Diagnóstico por Imágenes, Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Argentina
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Kitsche M, Terai N. [Orbital cavity tumor with macular folds]. Ophthalmologe 2018; 114:1031-1033. [PMID: 27933400 DOI: 10.1007/s00347-016-0416-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A 40-year-old patient presented with an orbital tumor of the right eye accompanied by visual impairment and macular folds. The diagnosis of mucocele was made through clinical and radiological investigations. The excision of the mucocele was performed immediately. As early as 8 weeks after the operation, an obvious increase in visual acuity was noticed. At this time, the macular folds were no longer detectable.
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Affiliation(s)
- M Kitsche
- Augenklinik der Medizinischen Fakultät "Carl Gustav Carus", Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland.
| | - N Terai
- Augenklinik der Medizinischen Fakultät "Carl Gustav Carus", Technische Universität Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
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Licci M, Zweifel C, Hench J, Guzman R, Soleman J. Frontoethmoidal Osteoma with Secondary Intradural Mucocele Extension Causing Frontal Lobe Syndrome and Pneumocephalus: Case Report and Review of Literature. World Neurosurg 2018; 115:301-308. [PMID: 29679781 DOI: 10.1016/j.wneu.2018.04.071] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Paranasal sinus osteoma is a common, asymptomatic, histologically benign, slow-growing tumor. However, it can give rise to secondary pathologies such as a mucocele in about 50% of the cases. Rarely, intracranial and orbital extension is present, leading to rhinoliquorrhea, pneumocephalus, or neurologic and visual impairment, which might be potentially life-threatening. CASE DESCRIPTION A 49-year-old man presented with an acute frontal lobe syndrome and rhinoliquorrhea. Cranial magnetic resonance tomography showed a suspected frontoethmoidal osteoma with a mucocele expanding intradurally into the left frontal lobe. It was accompanied by pneumocephalus and showed communication with the left lateral ventricle. Through a bifrontal craniotomy, in toto resection of the frontoethmoidal bony tumor and the intradural mucocele was performed, while thereafter the frontal sinus was cranialized using a pedunculated periosteal flap. Postoperative recovery was uneventful with complete resolution of the tension pneumocephalus and rhinoliquorrhea and led to an improvement of the frontal lobe syndrome. CONCLUSIONS We present a rare case of pneumocephalus caused by a frontoethmoidal osteoma associated with an intradural mucocele. A review of the literature, focusing on the surgical strategies in such cases, is provided.
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Affiliation(s)
- Maria Licci
- Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland
| | - Christian Zweifel
- Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland
| | - Jürgen Hench
- Department of Neuropathology, University Hospital of Basel, Basel, Switzerland
| | - Raphael Guzman
- Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland
| | - Jehuda Soleman
- Department of Neurosurgery, University Hospital of Basel, Basel, Switzerland.
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Lombardo N, Ferrise P, Piazzetta GL, Bruzzichessi D, Testa D, Viola P, Pelaia C, Motta G. Maxillary sinus mucocele with orbital complications. Ann Ital Chir 2018; 7:S2239253X18028190. [PMID: 29661986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Maxillary sinus mucocele is an unusual clinic entity (incidence of 3-10%), represented by mucous secretion lined by respiratory stratified pavemented epithelium and its origin is mainly secondary to infections, inflammations, surgery, trauma or neoplasia. CASE REPORT We present a case of maxillary sinus mucocele. Subject of the study is a 74 aged patient referring positive anamnesis for nasal cavity surgery. His symptoms appeared six months ago and he complainted vertical ocular diplopia and ocular tension sensation, without rhinologic complaints. Oculistic examination confirmed an isolated left inferior rectus palsy, and CT showed mucous secretion occupying left maxillary sinus, with bone erosion to the orbital floor until orbital muscles. MRI is the gold standard for differential diagnosis with neoplastic lesions but the patient refused to perform this radio-diagnostic exam. He underwent to Endoscopic sinus surgery, consisting in middle meatal antrostomy and removal of the mucocele. Four months later the endoscopic follow-up showed regular maxillary cavity and regular ocular motility. CONCLUSION In our opinion the rebuilding of the eroded bone is not mandatory if the integrity of the maxillary upper wall mucosa is respected, and antrostomy with drainage allows to recover ocular and paranasal sinus function. KEY WORDS:, Diplopia, Endoscopic sinus surgery.
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Lajmi H, Hmaied W, Ben Jalel W, Ben Romdhane K, Chelly Z, El Fekih L. Unilateral proptosis revealing a fronto-ethmoidal mucocele. Tunis Med 2017; 95:449-451. [PMID: 29512802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
UNLABELLED Backgroud: The fronto-ethmoidal mucocele is a benign condition leading commonly to limited eye movement or ocular pain but it could also induce visual acuity impairment by compressing the optic nerve Aim: To discuss, through a case report, different ophthalmologic manifestations of the fronto-ethmoidalmucocele. Reported case: A 46-years-old man with no general history consulted for a bilateral ocular redness and itching. He reported, however, a mild protrusion of his left globe evolving for oneyear. The clinical examination revealed a unilateral proptosis in the left eye with a discrete limitation of theadduction. A brain and orbital computer tomography (CT)and a magnetic resonance imaging(MRI)revealed a grade I exophthalmos caused by an oval formation of fluid density in the left anterior and posterior ethmoidal cells in addition to the frontal sinus,driving theeyeball and internal oculomotor muscles back and out.The patient was referred to otorhinolaryngology department for a precocious surgical management. CONCLUSION The ophtalmologic manifestations of the disease depend on the location, the size of the formation and involvement of adjacent structures. The loss of vision and the apex syndrome due to the compressionof the ocular globe are the most serious complications.
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Jiang Y, Gao J, Su W. [Significance of differential diagnosis for sinonasal mass by CT value]. Zhong Nan Da Xue Xue Bao Yi Xue Ban 2017; 42:55-59. [PMID: 28216498 DOI: 10.11817/j.issn.1672-7347.2017.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To explore whether CT value is useful in identifying different disease in tumors of rhinosinus parenchyma.
Methods: The data of preoperation noncontrast CT in 277 patients were retrospectively reviewed. The final diagnosis and classification were based on the result of surgical histopathological examination. The CT value range for different classification was calculated and was compared. All patients were re-diagnosed according to CT value range combined with pathological results by the same doctor team. The diagnosis rates according to CT value range were compared.
Results: The CT value was (25.3±3.5) Hu in nasal polyp, (7.9±3.5) Hu in serous cyst, (42.2±4.7) Hu in mucocele, (40.7±5.3) Hu in papilloma, (112.3±10.9) Hu in fungus ball, (41.7±4.8) Hu in hemangioma, (51.2±9.9) Hu in malignant melanoma, and (47.1±9.9) Hu in squamous carcinoma. The CT value in nasal polyp is significantly higher than that in serous cyst, which was significantly lower than that in mucocele, papilloma, fungus ball, hemangioma, malignant melanoma and squamous carcinoma (all P<0.05); the CT value in serous cyst was significantly lower than that in other classification diseases (all P<0.05); the CT value in fungus ball was significantly higher than that in other classification diseases (all P<0.05); there was no significant difference in CT value among mucocele, papilloma, hemangioma, malignant melanoma, squamous carcinoma (all P﹥0.05). The diagnosis rate was elevated (from 71.1% to 92.4%) according to CT value range, with significant difference (χ2=42.150, P<0.01).
Conclusion: CT value in nasal polyp, serous cyst, fungus ball is different from other diseases, and the 3 diseases can be distinguished only by CT value range; the CT value in mucocele, papilloma, hemangioma, malignant melanoma and squamous carcinoma is similar, and their differential diagnosis should combine with imaging data and other clinical characters. The diagnosis rates can be improved when the CT value range is taken into account.
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Affiliation(s)
- Yan Jiang
- Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Xiamen University, Xiamen Fujian 361000, China
| | - Jing Gao
- Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Xiamen University, Xiamen Fujian 361000, China
| | - Wenling Su
- Department of Otolaryngology Head and Neck Surgery, First Affiliated Hospital of Xiamen University, Xiamen Fujian 361000, China
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Duval M, Alsabah BH, Carpineta L, Daniel SJ. Respiratory Distress Secondary to Bilateral Nasolacrimal Duct Mucoceles in a Newborn. Otolaryngol Head Neck Surg 2016; 137:353-4. [PMID: 17666273 DOI: 10.1016/j.otohns.2007.03.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2006] [Accepted: 03/07/2007] [Indexed: 11/20/2022]
Affiliation(s)
- Melanie Duval
- Department of Otolaryngology, Montreal Children's Hospital, McGill University, Montreal, QC, Canada
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Abstract
INTRODUCTION Although encephalocele is a rare congenital abnormality, secondary encephalocele is extremely rare and can cause fatal complications. Here, we report a case of secondary encephalocele caused by frontal sinus wall defect due to chronic sinusitis, which was completely removed by cranialization with autologous bone graft. A 50-year-old man with a 10-year history of chronic sinusitis visited our hospital due to suddenly altered mentality characterized by stupor. Computerized tomography scanning and magnetic resonance imaging revealed an enlarged left frontal sinus with sinusitis. The frontal sinus cavity was calcified, and the left frontal lobe had herniated into the cavity accompanied by yellow pus. A large dural defect was also found around the frontal sinus area. After removal of the abscess and some of the frontal lobe, frontal skull base repair by cranialization was performed using autologous bone graft. Streptococcus pneumoniae was cultured from the cerebrospinal fluid (CSF), necessitating treatment with antibiotics. After the operation, the mental status of the patient improved and no CSF leakage was observed. DISCUSSION In addition to correct diagnosis and early treatment including antibiotics, the surgical repair of defects is needed in patients with secondary encephalocele to prevent further episodes of meningitis. Surgical correction of frontal sinus encephalocele can be achieved through bifrontal craniotomy or endoscopic transnasal repair. If a patient has CSF leakage, open craniotomy may facilitate repair of the dural defect and allow for cranialization of the sinus. CONCLUSIONS Removal of dysplastic herniated brain tissue and cranialization of the frontal sinus may be a good option for treating secondary encephalocele and its associated complications, including meningitis, abscess formation, and infarction of the herniated brain parenchyma.
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Affiliation(s)
- Byeong Ho Oh
- Department of Neurosurgery, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, 776, 1 Sunhwanro, Gaesindong, Sewongu, Cheongju, South Korea, 28644
| | - Ok-Jun Lee
- Department of Pathology, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Young Seok Park
- Department of Neurosurgery, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, 776, 1 Sunhwanro, Gaesindong, Sewongu, Cheongju, South Korea, 28644.
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Brown SM, Sadoughi B, Cuellar H, von Jako R, Fried MP. Feasibility of near real-time image-guided sinus surgery using intraoperative fluoroscopic computed axial tomography. Otolaryngol Head Neck Surg 2016; 136:268-73. [PMID: 17275552 DOI: 10.1016/j.otohns.2006.09.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2006] [Accepted: 09/25/2006] [Indexed: 11/15/2022]
Abstract
Objective One of the main limitations of image-guided surgery is that navigation relies on the use of a CT scan obtained before surgery and is unable to be updated during the procedure. A software addition has been developed to allow reconstruction of CT-like images from a series of fluoroscopic scans and integrate these into an image-guided system (GE Healthcare Surgical Navigation, Lawrence, MA). We report our initial experience with a series of patients undergoing intraoperative fluoroscopic navigation in sinus surgery. Study Design and Settings After institutional review board clearance, we prospectively studied 14 consecutive patients undergoing image-guided sinus surgery with the use of intraoperative fluoroscopy. Results All patients had preoperative and postoperative fluoroscopic images reconstructed into CT-like images. By the conclusion of the study, images were adequate in quality and accurate navigation was achieved. Conclusion Real-time image-guided sinus surgery using fluoroscopy is feasible. Future studies will need to focus on defining the procedures that could benefit, such as tumor resection, to enhance patient safety during these operations.
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Affiliation(s)
- Seth M Brown
- Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, Bronx, NY 10467, USA.
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Rathinam D, Madhusudhan KS, Srivastava DN, Dash NR, Gupta AK. Esophageal mucocele after surgical isolation of thoracic esophagus presenting with respiratory distress. Trop Gastroenterol 2016; 37:147-148. [PMID: 30234950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Nguyen T, Kuijpers D, Companjen J, Erceg A. [Intermittent swelling of the eyelid]. Ned Tijdschr Geneeskd 2016; 160:D92. [PMID: 27405576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Mucoceles are benign mucous-containing cysts that can occur in the sinuses. They arise as a result of an obstruction of the sinus ostium. There is often a delay in diagnosis because symptoms are so variable. CASE DESCRIPTION A 52-year-old woman had intermittent swelling of the eyelid. A CT scan of the sinuses showed a mucocele in the frontal sinus with breakthrough to the left orbit. Treatment consisted of marsupialisation by means of functional endoscopic sinus surgery with septum correction. CONCLUSION Breakthrough of a mucocele to the orbit should be considered in the differential diagnosis in patients with an intermittent swelling of the eyelid.
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Esseghaier S, Zouari N, Koubaa W, Jouini R, Haouas N, Chadly-Debbiche A, Daghfous MH. Retroperitoneal mucocele of appendicealstump : Radio-histological correlation. Tunis Med 2016; 94:78-79. [PMID: 27525611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Kesimer M, Cullen J, Cao R, Radicioni G, Mathews KG, Seiler G, Gookin JL. Excess Secretion of Gel-Forming Mucins and Associated Innate Defense Proteins with Defective Mucin Un-Packaging Underpin Gallbladder Mucocele Formation in Dogs. PLoS One 2015; 10:e0138988. [PMID: 26414376 PMCID: PMC4586375 DOI: 10.1371/journal.pone.0138988] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 09/07/2015] [Indexed: 12/18/2022] Open
Abstract
Mucosal protection of the gallbladder is vital yet we know very little about the mechanisms involved. In domestic dogs, an emergent syndrome referred to as gallbladder mucocele formation is characterized by excessive secretion of abnormal mucus that results in obstruction and rupture of the gallbladder. The cause of gallbladder mucocele formation is unknown. In these first mechanistic studies of this disease, we investigated normal and mucocele-forming dog gallbladders to determine the source, identity, biophysical properties, and protein associates of the culprit mucins with aim to identify causes for abnormal mucus behavior. We established that mucocele formation involves an adoptive excess secretion of gel forming mucins with abnormal properties by the gallbladder epithelium. The mucus is characterized by a disproportionally significant increase in Muc5ac relative to Muc5b, defective mucin un-packaging, and mucin-interacting innate defense proteins that are capable of dramatically altering the physical and functional properties of mucus. These findings provide an explanation for abnormal mucus behavior and based on similarity to mucus observed in the airways of people with cystic fibrosis, suggest that abnormal mechanisms for maintenance of gallbladder epithelial hydration may be an instigating factor for mucocele formation in dogs.
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Affiliation(s)
- Mehmet Kesimer
- Department of Pathology and Laboratory Medicine and Cystic Fibrosis/Pulmonary Research and Treatment Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - John Cullen
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Rui Cao
- Department of Pathology and Laboratory Medicine and Cystic Fibrosis/Pulmonary Research and Treatment Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Giorgia Radicioni
- Department of Pathology and Laboratory Medicine and Cystic Fibrosis/Pulmonary Research and Treatment Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Kyle G. Mathews
- Department of Clinical Sciences, College of Veterinary Medicine, Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Gabriela Seiler
- Department of Molecular Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Jody L. Gookin
- Department of Clinical Sciences, College of Veterinary Medicine, Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, North Carolina, United States of America
- * E-mail:
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Shidanshid M, Taghi AS, Kuchai R, Saleh HA. Endoscopic resection of a mucocele of the crista galli. Ear Nose Throat J 2015; 94:E23-E25. [PMID: 26401677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
Mucoceles expand by the process of bone resorption and new bone formation, which leads to local destruction and displacement of adjacent structures. We present the case of a 47-year-old woman who presented with recurrent headaches, nausea, and vomiting, all of which were believed to have occurred secondary to a mucocele of the crista galli. To the best of our knowledge, only 1 similar case has been previously reported in the world literature; in that case, the crista galli was drained externally. In our patient, resolution of symptoms was achieved by endoscopic dacryocystorhinostomy, endoscopic frontal sinusotomy, and drainage of the mucocele under image guidance. We recommend that an endoscopic surgical approach be considered for the management of mucoceles of the crista galli.
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Affiliation(s)
- Mani Shidanshid
- Department of Ear, Nose and Throat Surgery, Imperial College Healthcare NHS Trust, St. Mary's Hospital, Praed St., London W2 1NY, UK
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Lapayowker MS, Ronis ML. Problems in tumors of the ethmoid and sphenoid sinuses. Adv Otorhinolaryngol 2015; 21:19-31. [PMID: 4598719 DOI: 10.1159/000395084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Cristian DA, Grama FA, Becheanu G, Pop A, Popa I, Şurlin V, Stănilescu S, Bratu AM, Burcoş T. Low-grade appendiceal mucinous neoplasm mimicking an adnexal mass. Rom J Morphol Embryol 2015; 56:837-842. [PMID: 26429182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
We present a rare case of malignant epithelial neoplasm of the appendix, an uncommon disorder encountered in clinical practice, which poses a variety of diagnostic and therapeutic challenges. We report a particular case in which the appendix was abnormally located in the pelvis, mimicking an adnexal mass. Therefore, it was difficult to make the preoperative diagnosis on clinical examination, imaging studies and laboratory tests and we discovered the lesion during the diagnostic laparoscopy. No lymphadenopathy or mucinous ascites were found. The case was completely handled via the laparoscopic approach keeping the appendix intact during the operation. The frozen section, the detailed histopathology overview as well as multiple immunostaining with a complex panel of markers report diagnosed a low-grade appendiceal mucinous neoplasm (LAMN) with no invasion of the wall. No adjuvant therapy was considered needed. At a one-year follow-up oncological assessment, the patient was free of disease. In women with cystic mass in the right iliac fossa an appendiceal mucocele should be considered in the differential diagnosis. Laparoscopic appendectomy can represent an adequate operation for the appendiceal mucinous neoplasm if the histological report is clear and surgical precautionary measures are taken.
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Nilesh K, Chandra J. Atypical presentation of salivary mucocele: diagnosis and management. Gen Dent 2015; 63:e32-e34. [PMID: 25574732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
A mucocele is a common pathological lesion involving the minor salivary glands. It usually presents as an asymptomatic small superficial swelling over the lower labial mucosa. However, uncommon variants of oral mucoceles sometimes occur. Such lesions may be difficult to diagnose due to their unusual size and atypical clinical presentation. This article describes the case of a deeply embedded large mucocele over the buccal mucosa. Ultrasonography was used to visualize the size and position of the lesion, and aspiration was used to help in the eventual diagnosis. An intraoral approach was used in the complete removal of the lesion.
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Altıntaş Kakşi S, Kakşi M, Balevi A, Özdemir M, Çakır A. Unusual case of frontal mucocele presenting with forehead ulcer. Dermatol Online J 2014; 20:13030/qt8g60g2mg. [PMID: 25419750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 11/14/2014] [Indexed: 06/04/2023] Open
Abstract
Paranasal mucoceles are benign slow-growing paranasal sinus lesions, which usually develop following the obstruction of the sinus ostiu. They most frequently occur in the frontal sinus. Frontal mucoceles are expansive lesions usually causing visual clinical signs and symptoms such as diminution of vision, visual field defects, diplopia, orbital swelling, retroorbital pain, displacement of eye globe, ptosis, and proptosis. When the frontal mucocele extends intracranially, it can manifest with meningitis, meningoencephalitis, intracranial abscess, seizures, or cerebrospinal fluid fistula. Very rarely it can cause forehead swelling. We report an 80-year-old woman presenting with a forehead skin ulcer and painless subcutaneous forehead induration. Histopathologic examination revealed mucin deposition and inflammation. Computerized tomography (CT) and magnetic resonance imaging (MRI) scans showed a mass originating from the frontal sinus with frontal bony defect and frontocutaneous fistula. Surgical excision of the mass confirmed the mucocele diagnosis. In this article, we present a case of frontocutaneous fistula and skin ulcer, which is an unexpected complication of frontal mucocele. We propose that in the case of a localized non-healing ulcerated forehead skin lesions, mucocele should be considered in the differential diagnosis.
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Lee JY, Baek BJ, Byun JY, Shin JM. Long-term efficacy of inferior meatal antrostomy for treatment of postoperative maxillary mucoceles. Am J Otolaryngol 2014; 35:727-30. [PMID: 25113631 DOI: 10.1016/j.amjoto.2014.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 07/07/2014] [Accepted: 07/15/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE Transnasal endoscopic marsupialization has replaced the conventional Caldwell-Luc operation for managing postoperative maxillary mucoceles. Inferior meatal antrostomy (IMA) may be an easier and more effective method than middle meatal antrostomy (MMA) because of anatomical and structural changes of the maxillary sinus. We evaluated the long-term efficacy and technical simplicity of both methods. METHODS This study included 21 and 32 patients who underwent MMA and IMA, respectively. They were diagnosed with a unilateral postoperative maxillary mucocele, and medical records were reviewed for history, clinical presentation, radiographic findings, surgical intervention, complications, and outcomes. During follow-up, the size of the opening and stenosis or obstruction of the antrostomy site were evaluated. RESULTS Preoperative symptoms and mean follow-up period were similar in both groups. All patients in the IMA group received the operation as planned, whereas in four MMA patients, the attempt to create an opening failed because of thick bones and anatomical changes from the previous operation; in these patients, IMA was performed. The opening remained large enough for ventilation and drainage between the mucocele and the nasal cavity in both groups. There were no major complications, such as profuse bleeding, wound infection, or orbital or nasolacrimal duct injury. CONCLUSIONS Although both surgical procedures seem to be effective for managing postoperative maxillary mucoceles, IMA is easier to perform, and no instances of failure to create antrostomy openings occurred. We recommend IMA as the surgical technique of choice, but providing an opening of sufficient size is necessary to ensure long-term efficacy.
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Affiliation(s)
- Jae Yong Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea.
| | - Byoung Joon Baek
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea
| | - Jang Yul Byun
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Republic of Korea
| | - Jae Min Shin
- Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Seoul Hospital, Seoul, Republic of Korea
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Malya FU, Hasbahceci M, Serter A, Cipe G, Karatepe O, Kocakoc E, Muslumanoglu M. Appendiceal mucocele: clinical and imaging features of 14 cases. Chirurgia (Bucur) 2014; 109:788-793. [PMID: 25560502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2014] [Indexed: 06/04/2023]
Abstract
PURPOSE Appendiceal mucocele as a cystic dilatation filled with mucinous material is a very rare disease of the appendix vermiformis. Its preoperative diagnosis is still acking behind common use of imaging techniques. METHODS Retrospective analysis of the patients with a pathological diagnosis of appendiceal mucocele with regard to clinical and imaging features. RESULTS The study group included 14 patients with a mean age of 51 years (range from 17 to 82 years). Predominant symptoms were pain and feeling of fullness in the right iliac fossa in 9(64%) and 5 (36%) patients, respectively. For imaging purposes, use of computed tomography resulted in preoperative diagnosis of appendiceal mucocele in half of the patients(50%). 93% of the cases underwent appendectomy, and righth emicolectomy was performed in one patient (7%). Mucocele and cystadenoma were detected in 11 (79%) and 3 (21%)patients, respectively. Presence of acute appendicitis and coloncarcinoma were confirmed afterwards histologically in 4 (29%)and one (7%) patients, respectively. CONCLUSIONS Despite the common use of imaging studies,preoperative diagnosis of appendiceal mucocele is still not possible in most of the cases. During surgical treatment,which is tailored according to imaging and intraoperative findings, precautionary measures to avoid intraperitoneal rupture and dissemination should be taken.
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Abstract
BACKGROUND Frontal sinus mucocoeles require a structured approach to their surgical management. We share our experience of a novel method of positional classification for frontal mucocoele and corresponding surgical algorithm. METHODS A retrospective case-note review examined all frontal sinus surgery for mucocoele, spanning three years (2008-2010). Patients had pre-operative nasendoscopy, multi-planar CT and MRI when indicated. Several important variables (position, drainage dimensions, fronto-ethmoidal cells and degree of neo-osteogenesis) were noted. A systematic algorithm was used for surgical drainage based on these characteristics. The three year outcomes using this approach are presented. RESULTS Thirty-six patients were identified with a total of 43 frontal mucocoeles. Using our classification, 30 mucocoeles were medial; seven were intermediate; six were lateral. Thirty-four patients underwent a primary endoscopic procedure; six required a combined primary osteoplastic-flap (OPF) and endoscopic approach. Six patients required revision surgery for polypoidal change or neo-ostium stenosis. All patients were eventually rendered asymptomatic. CONCLUSION Implementation of our positional classification and surgical algorithm was successful with a revision rate of 19%. Presence of frontal sinus wall dehiscence and extra-sinus mucocoele extension are invalid indicators for external approach. We feel our classification and treatment algorithm, with its associated indicators for surgical escalation (i.e. limited dimensions of frontal ostium, presence of Type III / IV front-ethmoidal cells etc), are applicable for future management of frontal mucocoeles.
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Affiliation(s)
- C Hill
- From the ENT Department, Queen's Hospital, Romford, UK
| | - G Kumar
- From the ENT Department, Queen's Hospital, Romford, UK
| | - J S Virk
- From the ENT Department, Queen's Hospital, Romford, UK
| | - A Owa
- From the ENT Department, Queen's Hospital, Romford, UK
| | - H Kaddour
- From the ENT Department, Queen's Hospital, Romford, UK
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Mohebbi A, Jahandideh H, Harandi AA. Sphenoid sinus mucocele as a cause of isolated pupil-sparing oculomotor nerve palsy mimicking diabetic ophthalmoplegia. Ear Nose Throat J 2013; 92:563-565. [PMID: 24366704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
A 37-year-old woman presented with isolated right-sided oculomotor nerve palsy. Neurologic examination revealed no other disorder. Computed tomography of the paranasal sinuses demonstrated complete opacification of the sphenoid sinus. Dense mucoid fluid was drained from the sphenoid sinus via an endoscopic transseptal sphenoidotomy. A biopsy confirmed the diagnosis of sphenoid sinus mucocele. At follow-up 4 weeks postoperatively, the patient's ocular symptoms were markedly alleviated. Considering rare causes of isolated oculomotor nerve palsy, such as sphenoid sinus mucocele, is important in the differential diagnosis, even in patients with well-known risk factors such as diabetes mellitus.
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Affiliation(s)
- Alireza Mohebbi
- Department of Otolaryngology-Head and Neck Surgery, Hazrat-e-Rasool Akram Hospital, Niyayesh, Sattarkhan St., Tehran, Iran 1445613131
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Zainine R, Hachicha A, Charfeddine A, Beltaief N, Sahtout S, Besbes G. Concha bullosa pyocele. Tunis Med 2013; 91:563-564. [PMID: 24227525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Opreanu RC, Sobinsky J, Basson MD. Appendicitis and benign appendiceal mucocele presenting as large bowel obstruction. J Gastrointest Surg 2013; 17:609-10. [PMID: 23099734 PMCID: PMC3837578 DOI: 10.1007/s11605-012-2054-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 10/11/2012] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Appendiceal mucocele is most commonly encountered incidentally during appendectomy. METHODS We report a case of large bowel obstruction presenting as a closed loop with an appendiceal mucocele as the lead point, superimposed on a chronic ileal stricture that had been misdiagnosed as irritable bowel syndrome. RESULTS The patient underwent ileocecal resection and primary anastomosis. She did well postoperatively, and her irritable bowel syndrome disappeared. CONCLUSIONS Appendiceal mucocele can present in a variety of ways, and surgeons should be alert for atypical presentations. Moreover, some patients with intermittent abdominal pain deserve anatomic investigation before being dismissed as having irritable bowel.
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Affiliation(s)
- Razvan C Opreanu
- Department of Surgery, College of Human Medicine, Michigan State University, Lansing, MI 48912, USA
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Zaharie F, Tomuş C, Mocan L, Spârchez Z, Zaharie R, Iancu C. Intestinal obstruction secondary to appendiceal mucocele. Chirurgia (Bucur) 2012; 107:802-804. [PMID: 23294962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2012] [Indexed: 06/01/2023]
Abstract
Few cases of intestinal obstruction complicating an appendiceal mucocele have been recorded. We report the case of a young woman who presented to the emergency room with diffusely abdominal pain, nausea, vomiting and disruption of bowel movements. Her abdomen was mildly distended and tympanic. A flat film of the abdomen revealed dilated small bowel loops with air-fluid levels suggestive of small bowel obstruction. She also had leukocytosis. An emergency operation was performed under the diagnosis of intestinal obstruction. The intraoperatory findings showed a tumoral appendiceal mass permeated into the ileum in two distinct points, causing an enteral stenosis. We performed an appendectomy "en bloc" with two enteral loop resections of the permeated ileum followed by two T-T enteral anastomoses. The pathologic examination revealed appendiceal mucinous cystadenoma. Postoperative course was favorable, the patient being discharged on the seventh postoperative day. Postoperative checks performed at 3, 6, 12 and 24 months (including colonoscopy) have not showed pathological changes.
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Affiliation(s)
- F Zaharie
- 3rd Surgical Department, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Papoutsis D, Protopappas A, Belitsos P, Sotiropoulou M, Antonakou A, Loutradis D, Antsaklis A. Mucocele of the vermiform appendix misdiagnosed as an adnexal mass on transvaginal sonography. J Clin Ultrasound 2012; 40:522-525. [PMID: 21739436 DOI: 10.1002/jcu.20858] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2011] [Accepted: 05/19/2011] [Indexed: 05/31/2023]
Abstract
Mucocele of the vermiform appendix is a rare entity that may mimic a right-sided adnexal mass. We describe a case of appendiceal mucocele in a 78-year-old woman that was initially misdiagnosed as a potentially malignant right ovarian tumor and briefly review the literature on sonographic features of this entity. It is important to improve preoperative diagnosis so as to prevent rupture of mucocele at surgery, which may lead to pseudomyxoma peritonei, and also to seek intraoperatively for the presence of synchronous colorectal neoplasms.
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Affiliation(s)
- Dimitrios Papoutsis
- First Department of Obstetrics and Gynecology, University of Athens, Alexandra Hospital, Athens, Greece
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