Compressive Trigeminal Neuropathy after Caldwell-Luc Operation

Most postoperative maxillary cysts develop more than 10 years after a Caldwell-Luc operation. They can manifest with cheek pain, swelling and dental and visual symptoms. Brain imaging should be performed to distinguish trigeminal nerve compression from various other possible causes. It should be treated by surgical intervention to relieve the above-mentioned symptoms. We report a patient who presented with compressive trigeminal neuropathy caused by a postoperative maxillary cyst.

Compressive Trigeminal Neuropathy after Caldwell-Luc Operation

Most postoperative maxillary cysts develop more than 10 years after a Caldwell-Luc operation. They can manifest with cheek pain, swelling and dental and visual symptoms. Brain imaging should be performed to distinguish trigeminal nerve compression from various other possible causes. It should be treated by surgical intervention to relieve the above-mentioned symptoms. We report a patient who presented with compressive trigeminal neuropathy caused by a postoperative maxillary cyst.

Sudden Hemianopsia Secondary to Ethmoid Sinus Mucocele

Paranasal sinus mucoceles are benign cystic lesions, filled with mucus, occurring due to an obstruction of involved sinus ostium. They are indolent, locally expansive, and destructive. Surgical treatment must be performed and, when done at the correct time, may prevent sequelae. We present a case of ethmoid sinus mucocele with orbit involvement and permanent optical nerve injury...

A sphenoid sinus mucocele simulating as retro bulbar optic neuritis.

A 25-year-old male presented with complaints of sudden diminution of vision with pain on eye movement in the left eye which was diagnosed clinically as retro bulbar optic neuritis. However, magnetic resonance imaging (MRI) showed lesion consistent with sphenoid sinus mucocele. Early surgical removal of mucocele led to complete recovery of vision, contrast and visual field. A high index of suspicion is necessary for intracranial lesions in all cases of retro bulbar neuritis, especially those with atypical symptoms.

A Case of Ectopic Tooth in the Maxillary Sinus Associated with a Mucocele / 대한이비인후과학회지

Supernumerary, ectopic tooth eruption in a non-dental area is a rare entity. The ectopic development of tooth found in non-dental environment has been reported in places such as the nasal cavity, chin, maxillary sinus, mandibular bone, palate and orbital cavity. Ectopic tooth eruptions in the maxillary sinus are usually asymptomatic and are found incidentally during routine clinical or radiological investigations. The diagnosis is usually made by plain-film radiography. Computed tomography is indicated when an ectopic tooth is found prior to surgery. Standard treatment for an ectopic tooth is extraction of the tooth. Here, the authors present a case of supernumerary, ectopic tooth found in the maxillary sinus associated with a mucocele.

Frontoethmoidal Mucocele Presenting as Progressive Enophthalmos

In this case report we describe a 27-year-old man who presented with progressive enophthalmos for 5 months without any other associated ocular symptoms such as pain, diplopia, or visual disturbance. Computed tomography showed that his progressive enophthalmos originated from a frontoethmoidal mucocele and this caused destruction of the lamina papyracea and shrinkage of the ethmoidal air cell. Finally the enlarged orbital space caused an inward deviation of the eyeball. Endoscopic marsupialization was successfully performed by an otolaryngologist and did not result in any ophthalmologic sequelae. Although frontoethmoidal sinus mucoceles mostly frequently originates from orbital mucoceles, enophthalmic manifestations are very rare. Enophthalmic conditions are not as responsive to surgical interventions as exophthalmic conditions.

Isolated Sphenoid Sinus Mucocele Presenting as Third Nerve Palsy

A sphenoid mucocele often presents late due to its deep seated anatomical site. And it has varied presentation due to its loose relationship to the cavernous sinus and the base of the skull. We describe a case of large sphenoid sinus mucocele. A middle aged old man suddenly developed third cranial nerve palsy. Brain imaging study revealed an isolated sphenoid sinus mucocele, compressing right cavernous sinus. Endoscopic marsupialization of the mucocele via transnasal approach led to complete resolution of the third cranial nerve palsy. Involvement of the third cranial nerve in isolated mucocele is rare but important neurosurgical implications which must be excluded. In addition, proper and timely treatment must be performed to avoid permanent neurologic deficit.

Maxillary Sinus Mucocele as a Late Complication in a Patient Underwent Lefort I Procedure

PURPOSE: The authors report unusual one case of a patient presenting with maxillary sinus mucocele who had underwent Lefort I procedure 7 years ago. METHODS: Case report and literature review RESULTS: A 25 year old man came to us with fullness, pain and nasal obstruction on his left cheek area. He had a history of multiple operations due to cleft lip and palate since birth. Two jaw surgery was performed for correcting class III malocclusion 7 years ago. Computed tomography showed haziness, and fluid filled cystic mass on left maxillary sinus. Nasoendoscopy revealed the bulging of inferior turbinate and mucosa coincided in medial wall of maxillary sinus. Antrostomy with Caldwell-Luc approach was performed. Mucin contaning brownish exudate was leaked out. Severe inflammation of maxillary inner wall and exposure of 2 screws fixed previously were noticed. The curettage and marsupialization were accomplished. The symptoms of patient were improved after that procedure. CONCLUSION: Maxillary sinus mucocele is related with Lefort I procedure and it may occur even long after that procedure.

A Case of Recurrent Frontal Sinus Mucocele Complicated by Visual Disturbance and Treated by Endoscopic Marsupialization and Intrafrontal Stent Insertion

Paranasal sinus mucocele is a slowly expanding benign lesion which can occur as a result of obstruction in the sinus ostium or ostial tract. Frontal sinus mucocele differ from mucoceles of other sinuses in that the frontal outflow tract is usually narrower and less accessible. Since the introduction of endoscopic sinus surgical instrument and techniques, there has been an increasing trend towards the use of endoscopic transnasal technique for managing the paranasal sinus mucoceles. Some studies also recommend the use of intrafrontal stent to reduce the rate of restenosis of frontal sinus outflow tract. We experienced a case of recurrent frontal sinus mucocele complicated by visual disturbance and periorbital swelling. To treat this condition, an intranasal marsupialization was performed and an intrafrontal stent was applied. This paper reports the particulars of this case with a review of related literature.

Long-Term Outcomes of Transnasal Endoscopic Marsupialization through Middle, Inferior Meatal Antrostomy or Extended Middle Meatal Antrostomy in Maxillary Sinus Mucoceles

Backgroud and Objectives: There are few reports about long-term outcomes of transnasal endoscopic marsupialization of isolated maxillary sinus mucocele. The approach routes of endoscopic marsupialization in those papers were mainly through middle meatal antrostomy. However, it is difficult or impossible to treat maxillary sinus mucocele by transnasal endoscopic middle meatal antrostomy in some cases. The aim of this study was to investigate long-term outcomes of transnasal endoscopic marsupialization according to three different approach routes. Materials and Methods: We reviewed 20 consecutive patients underwent transnasal endoscopic marsupialization and followed up for at least 66 months, retrospectively. Ten patients were treated by transnasal endoscopic middle meatal antrostomy with marsupialization, four by inferior meatal antrostomy and six by extended middle meatal antrostomy. RESULTS: No evidence of recurrence and major complications were observed during follow-up periods ranging from 66 to 102 months (mean, 80 months) according to three different approach routes. CONCLUSION: Transnasal endoscopic marsupialization with the appropriate antrostomy route according to the location and bulging direction of maxillary sinus mucoceles is considered to be an effective therapeutic method with favorable long-term outcomes

Prolapsed Antral Mucosa: Variant of Maxillary Sinus Mucocele / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: An array of diseases may cause masses in the maxillary sinus. Among the various diseases, the prolapsed antral mucosa (PAM) presents an inflammed, swollen maxillary antral mucosa which becomes redundant and prolapsed into the nasal cavity through a widened natural ostium, mimicking an antrochoanal polyp. The purposes of this study were to introduce prolapsed antral mucosa and evaluate the differences between prolapsed antral mucosa and other diseases, particularly maxillary sinus mucocele. MATERIALS AND METHODS: We retrospectively analyzed 18 patients who were diagnosed with prolapsed antral mucosa at the Kangbuk Samsung Hospital between 1990 and 1998. The presenting signs and symptoms, endoscopic finding, radiological finding, histopathological finding were reviewed. RESULTS: Of the symptoms reported by patients in this study, nasal obstruction was the most frequent, followed by rhinorrhea, postnasal drip, foul odor and headache. Endoscopic findings showed protruding maxitlary antral mucosa into the middle meatus. On the CT, the prolapsed antral mucosa presented features such similar to antrochoanal polyp as unilateral and homogeneous soft tissue density which extended into the middle meatus. MR imaging was useful for differentiating the prolapsed antral mucosa from neoplasms and antrochoanal polyp. Prolapsed antral mucosa and maxilla sinus mucocele showed the same histopathological features such as epithelial lining of columnar or metaplastic squamous cells with varying glandular structures, and dense fibrous stroma intiltrated by infiammatory cells. CONCLUSIONS: The prolapsed antral mucosa is considered as a variant of maxillary sinus mucocele. History, physical examination, biopsy, CT and MM are useful for differentiating the prolapsed antral mucosa from other diseases. Although a prolapsed antral mucosa is rare, it should be considered in the diagnosis and the treatment of unilateral maxillary sinus lesion.

A Case of a Sphenoid Sinus Mucocele Protruding into Both Nasal Cavities: Transnasal Endoscopic Marsupialization

A sphenoid sinus mucocele is a rare condition that causes a variety of symptoms by creating pressure on important contiguous neurological and vascular structures. The lesion is difficult to diagnose due to the subtlety of its symptoms, but careful radiological evaluation, with CT and MRI, for example, can help to provide a correct assessment. Transnasal endoscopic surgery can potentially deliver dramatic reduction in the operative morbidity of surgery for paranasal sinus mucoceles by offering an approach that is minimally invasive under local anesthesia. We experienced a 37-year-old male patient with a large sphenoid sinus mucocele protruding into both nasal cavities. The patient was treated with transnasal endoscopic marsupialization.

Endoscopic Sinus Surgery in Paranasal Sinus Mucoceles / 대한이비인후과학회지

BACKGROUND: The term mucocele was introduced by Rollet in 1896 and Onodi gave the first histological description in 1901. A variety of conservative and radical surgical procedures have been introduced and each approach has its proponents and opponents. OBJECTIVES: The purpose of this report is to share the experiences of functional endoscopic sinus surgery for paranasal sinuse mucoceles. MATERIALS AND METHODS: Ten patients diagnosed as having paranasal sinus mucocele underwent endoscopic marsupialization from July 1989 to December 1996. The follow-up period was between 2 months and 69 months with a mean of 37.9 months. RESULTS: Endoscopic surgery was attempted in 4 ethmoid, 4 maxillary, 1 frontoethmoid and 1 frontal sinus mucocele. Five cases had preoperative proptosis, four had nasal stuffiness and three had ophthalmoplegia and visual disturbance, and two had frontal headache. Computed tomography scan revealed that 7 cases had erosion of sinus wall. No disease recurrence has been noted to date with endoscopic follow-up of up to 69 months. CONCLUSION: Functional endoscopic sinus surgery provides good surgical results in the treatment of frontal, ethmoid, and maxillary sinus mucoceles with the advantage of restoration of functional drainage system.

Endoscopic Surgery for Paranasal Sinus Mucocele / 대한이비인후과학회지

BACKGROUND: Mucoceles of the paranasal sinus are slowly expanding epithelial lined lesions containing inspissated mucus that may erode bone and extend intraorbitally or intracranially. Mucoceles are thought to arise as a result of obstruction of the sinus ostium secondary to inflammation, fibrosis, trauma, previous surgery, or a mass lesion. Mucoceles most frequently arise from the frontal sinus and anterior ethmoid air cells, presenting with proptosis, frontal headaches, and reduced ocular mobility, especially on upward gaze. OBJECTIVES: The surgical approach to paranasal sinus mucoceles has followed two lines. The first is radical exenteration of the mucoceles and its whole lining: the other is marsupialization, leaving part of the lining intact. MATERIAL AND METHOD: This paper was analyzed 9 cases of paranasal sinus mucoceles which had operated in Chonbuk National University Hospital between January 1992 and August 1996. Eight cases were treated via intranasal endoscopic sinus surgery and one case via extranasal approach. RESULTS: There were no significant complications following surgery with a follow-up of 5 months to 2 years. CONCLUSION: So, we report the clinical findings, surgical treatment of 9 cases of mucoceles with review of literature.

A Case of Sphenoid Sinus Mucocele / 대한이비인후과학회지

Mucocele of the sphenoid sinus is a rare disease, and its signs and symptoms are different depending on multiple contiguous neurologic and vascular structures. So it is occasionally misdiagnosed as pituitary tumors. But careful radiologic evaluation including CT scan, helps in the correct assessment of this lesion. We have recently experienced one case of sphenoid sinus mucocele which presented with subtle nasal symptom. The mucocele was removed by endoscopic intranasal sphenoethmoidectomy.

Clinical analysis of endoscopic minimally invasive surgery for sphenoidal and ethmoidical mucoceles / 第三军医大学学报

Objective To evaluate endoscopic minimally invasive surgery in the treatment of sphenoidal and ethmoidical mucoceles. Methods A total of 25 patients diagnosed as sinus mucoceles, 10 in the sphenoid sinus and 15 in the ethmoid sinus, were subjected in this study, who underwent endoscopic marsupialization in our department from 1998 to 2000. Postoperatively, the patients were followed from 1 to 3 years. Results All 25 sphenoidal and ethmoidical mucoceles were satisfactorily approached endoscopically, and operating cavities received satisfactory marsupialization. The symptoms were improved or relieved in 23 patients. None had significant complications. Conclusion Endoscopic minimally invasive surgery is a safe and valuable way in the treatment of sphenoidical and ethmoidical mucoceles.

Sphenoid Sinus Mucocele Complicated With Spontaneous CSF Rhinorrhea: Case Report

Mucocele is commonly found in frontal sinus. Mucocele of sphenoid sinus is rare and only 100 cases have been reported since Burg's description in 1889. Their etiology is still conjectural. These lesions are potentially more serious and are often misdiagnosed as pituitary tumor. The author experienced a case of sphenoid sinus mucocele develped headache, fever and CSF rhinorrhea. Plain skull, cisternography brain CT scan help the diagnosis of sphenoid sinus mucocele. A transnasal approach is considered best for case with extensive sphenoid sinus mucocele with bone destruction in the floor of sella turcica. The headache, fever and CSF rhinorrhea improved after surgery.