[Surgery of mucocele of the paranasal sinuses: report of 52 cases with a middle term follow up]

Abstract

Objective: To define indications and limitations of Functional Endoscopic Sinus Surgery (FESS) for mucoceles therapeutic management.

Patients and methods: 52 cases of mucoceles were treated in our institution during the 8-year period 1993-2001. All patients underwent follow-up for a minimal period of 4 years, with a clinical (endoscopy) and imaging assessments, in order to diagnose recurrences.

Outcomes: Distribution of mucoceles location was: fronto-ethmoid sinus (25 cases), maxillary sinus (10 cases), anterior ethmoid sinus (3 cases), posterior ethmoid sinus (8 cases), sphenoid sinus (4 cases) and nasal cavity (2 cases). Thirty eight patients had undergone a nasal (1 septoplasty, 2 rhinoplasties) or sinusal surgery in their history. Recurrences were reported in 2 cases (3.8%). These 2 patients presented primarily with nasal polyps (nasal polyposis or cystic fibrosis) and both recurrences involved fronto-ethmoid sinuses.

Discussion and conclusion: Mucoceles involve quite commonly the maxillary sinus and the frontoethmoid sinus. Exclusive FESS with large opening of the mucocele (marsupialization) is an efficient therapeutic procedure. FESS procedure should be a procedure of first choice for mucocele management as it is highly efficient and has a low morbidity. Nevertheless, latero-frontal sinus mucoceles might be difficult to cure with FESS. Recurrences most likely occur in patients with associated ethmoidal inflammatory diseases.