Presentation
CONCLUSIONS: Paranasal sinus mucocoeles present most commonly with ophthalmic symptoms and signs. Patients with this condition are therefore highly likely to present initially to the ophthalmology department. [ncbi.nlm.nih.gov]
Clinical presentation of head and eye symptoms Figure 1. [intechopen.com]
Entire Body System
- Foul Smelling Discharge
Figure 4 shows a radiological image of left maxillary mucocele in an adult patient with nasal blockage and foul smelling discharge. [intechopen.com]
Respiratoric
- 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]
- Nasal Voice
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]
Eyes
- Unilateral Proptosis
Fronto-ethmoidal mucocoele as a cause of unilateral proptosis. Br J Ophthalmol. 1968; 52 (11): 833-8[ PubMed ] 5 Kuran G, Vuralkan E, Saka C, Akin I. Endoscopic sinus surgery of frontal mucocele. [thritajournal.com]
Psychiatrical
- Suggestibility
Characteristic radiographic findings can suggest the preoperative diagnosis, although a sphenoid sinus mucocele may simulate more serious conditions. [ncbi.nlm.nih.gov]
Face, Head & Neck
- Facial Scar
When used by surgeons familiar with endoscopic sinus surgery this has proved a safe and successful procedure that avoids facial scarring. [ncbi.nlm.nih.gov]
If a wide marsupialization can be achieved by an entirely endoscopic approach there are a number of advantages, notably a lack of facial scarring in children and young adults. [scienceopen.com]
- Facial Edema
[…] pain, decreased visual acuity, diplopia, displacement of the eyeball and facial edema. 1,2 With regard to treatment, endoscopic endonasal surgery is currently the most commonly used surgical approach in Europe and the U.S.A. 2–6 In Latin America, there [elsevier.es]
The clinical picture varies according to the involved region, which may cause facial pain, headache, nasal obstruction, diplopia, reduction of visual acuity, displacement of ocular globe, facial edema, cerebral abscess, pneumoencephaloceles and meningitis [scielo.br]
- Hypertelorism
Mucocele of the paranasal sinuses as a cause of orbital hypertelorism. European Journal of Plastic Surgery, Vol. 9, Issue. 4, p. 162. CrossRef Google Scholar Ormerod, L. David Weber, Alfred L. Rauch, Steven D. and Feldon, Steven E. 1987. [cambridge.org]
Neurologic
- Cranial Nerve Involvement
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]
The cranial nerves involved are II through VI [1]. Oculomotor, abducens, and optic nerves are the commonly involved nerves [11,12]. Involvement of the oculomotor, trochlear and abducens nerves leads to ophthamoplegia. [elynsgroup.com]
- Focal Neurological Deficit
Pressure effects on the cranial nerves can result in sudden focal neurological deficits such as blindness if the cavernous part of the carotid sinus is involved laterally. [ejo.eg.net]
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]
Serum
- Hyperprolactinemia
A case of mucocele of the sphenoid sinus causing sudden onset of blindness and hyperprolactinemia. Korean J Otolaryngol 1989;39:730–733. 20. Cho SH, Cho KK, Lee KS, et al. A case of sphenoid sinus mucocele with visual field defect. [synapse.koreamed.org]
Microbiology
- Alternaria
Infections by dematiaceous fungi such as Bipolaris, Curvularia or Alternaria are commonly seen in patients with allergic fungal sinusitis. [intechopen.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]
Conclusions This study confirms that over the last 9 years significant changes have occurred in the surgical treatment of paranasal mucocele in our hospital, as endoscopic surgeries increased from 34% to over 90% as the first option of treatment for mucoceles [elsevier.es]
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]
Treatment and prognosis In general, drainage and marsupialisation 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]
Since dural invasion implies both a worse prognosis and a surgical resection not limited to the eroded bone, the goals of imaging focus on establishing the depth of skull base invasion (Kraus et al. 1992b; Shah et al. 1997). [78stepshealth.us]
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]
Obstruction of the sinus ostium has been suggested as the primary etiologic factor. [joomr.org]
The etiology is either embryologic or secondary to trauma or an infective process. [intechopen.com]
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]
[…] possibility that the lesion can be diagnosed and completely removed without the need of craniotomy. 9 On the other hand, some authors prefer a transcranial extension to anterior mucoceles with intracranial extension to ensure complete removal and to prevent [jpma.org.pk]
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]