Development of Paranasal Sinus Mucocele Following Endoscopic Sinus Surgery

ABSTRACT

Backround and Objectives: Mucocele of the paranasal sinuses could be developed as secondary to trauma, tumor or surgical manipulation. This study was conducted to investigate clinical eatures of paranasal sinus mucocele following endoscopic sinus surgery and to determine the effect of endoscopic wide marsupialization for the treatment of mucocele. MATERIALS AND METHODS: Thirty-five patients with paranasal sinus mucocele who were diagnosed and surgically treated at Seoul National University Hospital from Nov. 1996 through Dec. 2002 were retrospectively analyzed by their medical records and radiological imaging. RESULTS: The most common chief complaint of patients with mucocele were ocular symptoms including periorbital swelling, proptosis and headache. Previous sinus operation, especially endoscopic sinus surgery was the most common cause of mucocele, which developed at mean period of 50 months after surgery. Most commonly involved sinuses were ethmoid and frontal sinuses. Thirty-three out of 35 patients underwent endoscopic wide marsupialization of the mucocele cavity, and the other two patients were treated via external approaches. No recurrence was observed until mean followup of 33 months. CONCLUSION: One should suspect the possibility of mucocele recurrence if a patient complains of ocular symptoms several years after endoscopic sinus surgery. Meticulous operation and postperative treatment, and regular followup are needed for patients who underwent endoscopic sinus surgery because of a possible development of mucocele as a late complication. Although transnasal endoscopic wide marsupialization for the treatment of mucocele showed safe and good results, long term follow-up data is needed to establish it as the gold standard for treatment of paranasal sinus mucocele.