ABSTRACT
AIM: An obstructive condition of paranasal sinus secondary to surgery, trauma, flogosis or neoplasms could become a predisposing state to the occurrence of mucocele. Frontal sinus mucoceles, which can turn into mucopyoceles due to bacterial super-infections, may invade the orbit, erode the skull base and displace respectively the ocular bulb and the frontal lobe. The surgical treatment of this disease ranges from mini-invasive approaches, such as the transnasal endoscopic marsupialization, to a more aggressive surgery such as osteoplasty through coronal flap and frontal sinus exclusion by fat tissue. METHODS: From 2005 to 2007, we treated with transnasal endoscopic surgery 10 patients, affected by frontal sinus mucopyoceles displacing both the ocular bulb and the frontal lobe. RESULTS AND DISCUSSION: In the present study, we report the clinical and diagnostic features of this series, the treatment modalities and the achieved results and confirm the effectiveness of the mini-invasive transnasal endoscopic technique in the treatment of the frontal sinus mucopyocele.
Subject(s)
Endoscopy/methods , Frontal Sinus/surgery , Minimally Invasive Surgical Procedures/methods , Mucocele/surgery , Paranasal Sinus Diseases/surgery , Adult , Aged , Facies , Female , Frontal Lobe/diagnostic imaging , Frontal Lobe/pathology , Frontal Sinus/diagnostic imaging , Frontal Sinus/pathology , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Mucocele/diagnostic imaging , Mucocele/pathology , Nose , Orbit/diagnostic imaging , Orbit/pathology , Paranasal Sinus Diseases/diagnostic imaging , Paranasal Sinus Diseases/pathology , Retrospective Studies , Surgical Flaps , Tomography, X-Ray ComputedABSTRACT
Tension pneumocephalus is a rare form of pneumocephalus in which the air is under pressure; it is generally due to communication between the atmosphere and the intracranial cavity, and is an infrequent (0.88%) complication of cranial trauma. Tension pneumocephalus causes an increase in intracranial pressure with deterioration of the neurological situation and requires emergency treatment. Endoscopic surgery of the paranasal sinuses, which is generally applied in the diagnosis and treatment of fistulas with cerebrospinal fluid leakage, was here used to treat a case of pneumocephalus due to cranio-ethmoidal communication, in a patient we had treated previously for severe cranio-facial trauma.