Mucocele of the Paranasal Sinuses - Retrospective Analysis of a Series of Seven Cases.

AIM: The present study aimed at identifying the risk factors, typical clinical symptoms and applied treatment in seven cases with mucocele of the paranasal sinuses. MATERIALS AND METHODS: Seven patients suffering from mucocele of the paranasal sinuses were admitted to the Clinic of Neurosurgery and the Clinic of Ear, Nose and Throat Diseases between 2014 and 2016. There were 4 females and 3 males aged between 22 and 78 (95% CI [31.44, 70.23]). Initial symptoms, their duration, clinical presentation upon admission, localization of the mucocele, type of surgical intervention and outcome have all been studied. RESULTS: The localization of the mucocele was frontal (2 cases), fronto-ethmoidal (2 cases), ethmoidal (1 case) and spheno-ethmoidal (2 cases). Risk factors were identified in 4 cases. Endoscopic marsupialization of the mucocele was performed in 5 cases. One patient with intracranial extension of frontal mucocele was treated via right frontobasal craniotomy. One of the patients refused surgery. CONCLUSION: Endoscopic marsupialization should be considered as a method of choice in cases with mucoceles without extensive intracranial invasion. This approach offers adequate drainage, balloon dilatation of the natural sinus openings that prevents future recurrence.

Endonasal treatment of postsaccal stenoses of lacrimal ducts: intranasal retrograde probing in congenital stenosis.

UNLABELLED: Congenital stenosis of nasolacrimal duct is a common medical problem affecting up to 20% of newborn infants. When symptoms persists for more than 5 to 6 months the lacrimal ducts should be subjected to probing and irrigation. Anterograde probing through inferior lacrimal punctum using a rigid Bowman probe is the standard approach to such cases. We could not find reports of a retrograde endonasal probing of the lacrimal ducts in the available literature published in the last five years. MATERIAL AND METHODS: Between 1992 and 2002, we treated 328 children (136 boys and 192 girls) with congenital stenoses of the lacrimal passageways. The mean age of the children was 7.4 (Sx +/- 13) months. Endonasal probing and retrograde irrigation of lacrimal ducts were performed in all children, taking into consideration the individual peculiarities of the obstruction and the anatomical accessibility of the opening of ductus nasolacrimalis in the inferior nasal passageway. RESULTS: Outflow of irrigation fluid from lacrimal puncta was observed at the first probing in 90% out of a total number of 401 primary probings. Because of persistent membranes in the inferior lacrimal punctum in 3 cases (0.8%) we had to repeat the initial dilatation. The repeated probing failed to ensure reliable establishment of lacrimal duct patency only in 1% of the cases. In such children we recommended and performed endonasal dacryocystorhinostomy with balloon intubations placing a catheter and this restored lacrimal drainage to the nasal cavity. CONCLUSION: Endonasal probing and irrigation of lacrimal ducts used in the treatment of congenital stenoses is a highly effective (99%), physiologically consistent and little traumatic method of reestablishing the patency of the tear draining system. If it fails, endonasal dacryocystorhinostomy with stents is the definitive treatment of children's dacryocystitis.