Presentation
Methods Two independent authors systematically reviewed articles describing outcomes after endoscopic sinus surgery for paranasal sinus mucoceles presenting with visual loss. [ncbi.nlm.nih.gov]
If large bony defects are present, reconstructive surgery may be necessary (e.g. of the orbital floor). If drainage remains impaired, the mucocele may recur. [radiopaedia.org]
Entire Body System
- Swelling
The most common (64.4%) presenting feature was peri-orbital swelling, often associated with pain and tenderness. [ncbi.nlm.nih.gov]
Occasionally, the mucoceles put pressure on the superior alveolar nerves, causing pain and swelling and fullness of the cheeks. The lesion expanding in the back may loosen the posterior teeth. [nasodren.com]
Although CT showed mild mucosal swelling or partial opacifications in bilateral sinuses, it was hard to identify the causative legion of optic neuropathy. [tandfonline.com]
- Inflammation
Together with our recent report showing that lipopolysaccharide is highly detected in mucocele fluid, the data from this study suggest that the Th1 response induced by lipopolysaccharide may affect the immunological inflammation in the epithelium of paranasal [ncbi.nlm.nih.gov]
The cellular infiltrate present within the lining mucosa include components of both acute and chronic inflammation. [sites.google.com]
Trauma, bony neoplasams, polyps and intra-antral inflammation contribute to the development of mucoceles. These mucus filled mucoceles feature mucoperiosteum of the sinus affected. [nasodren.com]
In our 10 patients, six had inflammation, two had nasal polyposis, and two had complications with a history of previous surgeries. [ejo.eg.net]
Etiology of such mucoceles is not well understood, and it is postulated that they ensue due to obstruction of the ostium by inflammation or previous procedures such as Caldwell-Luc surgery. [joomr.org]
- Asymptomatic
Four patients had symptoms of headache, diplopia, visual field defect, and forehead swelling, and 1 patient was asymptomatic. ESS was performed under general anesthesia in all cases, and the symptoms improved postoperatively. [ncbi.nlm.nih.gov]
Conclusion Owing to their similar radiographic features and asymptomatic presentations, AP, SCC, and MMS can be misdiagnosed. [oapublishinglondon.com]
The patient was aware that a mass was visible on previous computed tomography (CT) scan, but he was not treated appropriately as the lesion was asymptomatic. [journals.lww.com]
Follow-up CT scans after 6 months showed an open and self draining cavity with no evidence of recurrence.The patient remains so far asymptomatic clinically ,as well (Figure 4). [ispub.com]
- Surgical Procedure
All patients were treated with endoscopic surgical procedure. Authors also looked for etiological factors. RESULTS: Cystic fibrosis was found in 6 cases out of 10. [ncbi.nlm.nih.gov]
We classified the location and symptoms in all patients with diagnosis of paranasal mucocele, to demonstrate changes in the surgical procedure and approach. [elsevier.es]
Rhinologic surgeons should consider the endoscopic technique as the surgical procedure of choice for management of paranasal sinus mucoceles. [ispub.com]
Management Mucoceles are ideally managed surgically. Before the advent of endoscopic procedures, External frontoethmoidectomy was considered to be the ideal management modality. Classification of surgical approaches: I. [entscholar.wordpress.com]
- Fever
He did not give any history of nasal or paranasal infection or fever. On general physical examination, there was no abnormality detected. [elynsgroup.com]
Pseudo-pneumatized sinus Pseudo-pneumatized sinus Role of CT and MR (2) On the left a T2W-image in an immuno-compromised patient with fever. Initially a MRI was performed to rule out sinusitis. [radiologyassistant.nl]
There was no history of nasal obstruction or discharge, loosening of teeth, epiphora, hyposmia or anosmia, trismus, or fever. The patient was conservatively treated, initially by a dentist with oral antibiotics and anti-inflammatory drugs. [joomr.org]
As mucocele becomes infected, it is called mucopyocele and may course with sinusitis, orbital cellulitis, erythema, fever and pain. [scielo.br]
Respiratoric
- Rhinitis
The symptoms of sinus include forehead-specific trauma, the frontal sinus fracture, obstruction in the frontonasal duct, prolonged allergic rhinitis and nasal obstruction. The symptoms may persist up to several years. [nasodren.com]
The most common factors were facial trauma, allergic rhinitis and chronic rhinosinusitis, at 10.17% for each factor (Fig. 1). [elsevier.es]
- Postnasal Drip
Cysts that put pressure on the mucosal lining of sinuses cause symptoms such as headache and periorbital or facial pain, and those that obstruct the ostium may cause paranasal sinus infection, nasal obstruction, postnasal drip, and nasal discharge, which [alliedacademies.org]
Gastrointestinal
- Vomiting
Case Summary: A male patient aged 18 years presented with three weeks history of worsening headache and vomiting. There was history of blurring of vision resulting in blindness in both eyes. [elynsgroup.com]
Sites of involvement of paranasal sinuses Headache Diplopia Proptosis Reduced vision Reduced eye movement Nasal symptoms Vomiting Number of cases 7 2 5 3 2 5 1 Table 3. Clinical presentation of head and eye symptoms Figure 1. [intechopen.com]
Eyes
- Diplopia
Other presenting features included diplopia, proptosis, hypoglobus, diplopia, decreased colour vision, epiphora, facial swelling and nasal polyps. The frontal sinus was the most commonly (70%) involved site. [ncbi.nlm.nih.gov]
The patient may complain about nasal obstruction, nasal voice, proptosis, diplopia and headache. The affected frontal sinus will appear as a cloud with rounded, ovoid or smooth contours on the radiograph. [nasodren.com]
Frontal and ethmoid sinus mucoceles are usually present with ophthalmic symptoms such as proptosis and diplopia. [journals.lww.com]
Neurologic
- Headache
Reoperation was required in 1 patient (20%) because headache developed with obstruction of the frontal drainage route 7 months after ESS. [ncbi.nlm.nih.gov]
The most common clinical presentation was headache followed by eye and nasal symptoms (Table 3). Figure 1 shows a radiological image of a right ethmoidal mucocele in an adult patient with diplopia and headache. [intechopen.com]
Case 2 M.A.L, Caucasian female patient, complaining of nasal obstruction and left frontal headache with displacement of the eye ipsilaterally for 6 months. [scielo.br]
Workup
X-Ray
- Sinus Opacification
There are certain recurring patterns of inflammatory sinus disease that may be seen on sinus computed tomography (CT). 2 These include: the infundibular pattern, with inflammation of the maxillary sinus and opacification of the ipsilateral ostium and [appliedradiology.com]
Treatment
Abstract Several controversies still exist regarding the etiopathogenesis, diagnosis, and type of surgical treatment used in response to paranasal sinus mucocele. [ncbi.nlm.nih.gov]
Clinical characteristics of primary paranasal sinus mucoceles and their surgical treatment outsome. Korean J Otolaryngol 1998;41:1436–1439. 32. Shin HS, Lee BJ, Kim JH, et al. [synapse.koreamed.org]
Prognosis
Because of cranial nerve involvement, mucoceles in the posterior paranasal sinuses had a worse prognosis than those in the anterior paranasal sinuses. [ncbi.nlm.nih.gov]
Review each disease's clinical features, pathology, differential diagnosis, treatment, and prognosis quickly thanks to a concise, user-friendly, bulleted format.Consider cytopathology, special stains, and cytogenetics where appropriate.Compare different [books.google.com]
Treatment and prognosis In general, drainage and marsupialization of an affected sinus are sufficient. If large bony defects are present, reconstructive surgery may be necessary (e.g. of the orbital floor). [radiopaedia.org]
Prognosis The importance of accurate pretreatment evaluation and staging with paranasal sinus tumors is critical, the stage and type of the paranasal sinus tumor are the most important factors in determining the prognosis. [skullbaseinstitute.com]
Etiology
Authors also looked for etiological factors. RESULTS: Cystic fibrosis was found in 6 cases out of 10. Others etiological factors were trauma and inflammatory process; one case was strictly idiopathic. [ncbi.nlm.nih.gov]
There are some disagreements over the etiology of the mucoceles (7, 8). [thritajournal.com]
Etiology: Mucoceles are fairly uncommon, and in 1/3 of cases occur without any predisposing factors. It is so slow growing that there may be a considerable time lag between the initiating factor and the clinical presentation of mucocele. [sites.google.com]
Obstruction of the sinus ostium has been suggested as the primary etiologic factor. [joomr.org]
Pathophysiology
Thorough discussions of anatomy and pathophysiology of a variety of frontal sinus diseases provide a background for in-depth chapters on aspects of both medical and surgical management. [books.google.com]
The pathophysiology is believed to be due to poor drainage of mucosal secretions from the obstructed sinus. [ejo.eg.net]
Pathophysiology of the mechanism of bone reabsorption produced by mucoceles is still obscure. [scielo.br]
The underlying pathophysiology may be caused by direct compression on the nerve lesions, nonperfusion of the blood vessels that lead to ischemic orbital nerve or inflammation in response to infection around the nerve. [transbiomedicine.com]
Prevention
This complication can be prevented by taking care not to damage normal mucosa. Retention of healthy mucosa in the middle meatal area prevents adhesions from occurring. [entscholar.wordpress.com]
[…] of the mass from the skull base and preventing the risk of cerebrospinal leak. [ejo.eg.net]
This places the other (combined) technique at a disadvantage and thereby prevents the detection of any possible significant association, even if there really is one. [elsevier.es]
Determining the extent of removal of the mucocele is very important to prevent recurrence and should be carefully planned. 4 Conclusions Sinonasal mucocele, which can cause severe vision loss or visual complications, should be treated as quickly as possible [journals.lww.com]
Alternatively, frontal sinus osteoplastic approach with fat obliteration may be preferred inorder to prevent the collapse of the anterior wall.These procedures have significant surgical morbidities including scarring, cosmetic deformities and paresthesias [ispub.com]