Paranasal mucoceles: usual and unusual

ABSTRACT

The aim of this study was to review the usual and unusual aspects regarding the clinical presentation, diagnosis, and treatment of paranasal sinus mucoceles. Special emphasis was given to the role of endoscopic marsupialization either alone or in combination with a limited external procedure in creating a functioning epithelialized pathway between the mucocele and the sinonasal cavity. The medical records of all patients with mucoceles who were treated by the author over a five-year period were reviewed. There were 37 mucoceles, including 12 frontoethmoidal, 11 sphenoidal/sphenoethmoidal, 7 maxillary and 7 lesions arising from aberrant locations within the sinonasal complex. CT scan was the initial diagnostic modality in all patients. In ten patients, MRI was carried out to confirm the diagnosis. Endoscopic marsupialization was the only surgical modality in 32 patients. Four patients underwent surgery via combined endoscopic and limited external approach. Recurrence was reported in one patient 6 months following endoscopic marsupialization of sphenoid mucocele. Postoperative endoscopic examination showed a widely patent healed opening in 33 cases and asymptomatic cicatricial narrowing in 2 cases. The author concluded that well-planned simple or extended endoscopic technique either alone or in combination with a limited external procedure is uniquely suited to the management of virtually all mucoceles