Mucoceles of Paranasal Sinuses: A Single Centre Experience

Abstract

Describe experience of managing paranasal sinus mucoceles, with either endoscopic endonasal approach (EESS) or combined external with EESS approach. Retrospective study done at SDMCMS&H, between 2007 and 2019, on patients undergoing surgical excision of mucocele. Results described as mean, median, mode, percentages. Twenty-one patients were included, with male to female ratio (0.75:1), mean age (42.95 years). Commonest presentation were facial pain (42.85%),visual symptoms (28.57%), headache (23.80%). Signs included, proptosis (52.38%), facial deformity (23.80%). Imaging: showed frontal mucoceles (42.85%), fronto-ethmoid (38.09%), ethmoid (14.28%), sphenoid (4.76%). Orbital extension in 42.85%, sinusitis (33.33%), skull base erosion (23.80%). EESS or combined external and EESS approach (61.90%, 38.09% respectively) were performed. Complete excision of mucocele wall done. Recurrence in two cases(average-2.5 years),revision surgery performed without further recurrences. Either EESS or combined external and EESS approach used based on site and extension of mucoceles. Complete peeling of mucocele wall without obliteration of the sinus cavity was the mode of surgical management in all cases.

Keywords: Frontal; Mucoceles; Paranasal; Sinus.

Fig. 1

a Preoperative and b post-operative picture of patient who presented with right proptosis

Fig. 2

a Preoperative CT scan of serial coronal cuts showing right fronto-ethmoidal mucocele with partial erosion of roof of orbit and fovea and compression of orbital structures, b post-operativeCT scan of same patient, with intact dura

Fig. 3

Pre-operative (a) and post-operative (b) picture of patient who presented with left proptosis

Fig. 4

a Preoperative CT-PNS of same patient showing left frontal mucocele with erosion of the superior wall of orbit and compression of orbital structures, b post-operative CT of same patient

Fig. 5

Preoperative ct scan of patient with left frontal mucocele who presented with left infraciliary discharging fistula

Fig. 6

a intra operative picture of the same patient showing external approach with incision around the fistulous opening, b post-operative picture of the same patient with healed operative site