Mucocele of the Paranasal Sinuses: Retrospective Analysis of a Series of Eight Cases

Nasir A Magboul; Atheer A Alzubaidi; Lamya A Abumsmar; Ali Alzarei; Mohammad Al-Ahmari; Mona A Alshehri

doi:10.7759/cureus.41986

Mucocele of the Paranasal Sinuses: Retrospective Analysis of a Series of Eight Cases

Cureus. 2023 Jul 17;15(7):e41986. doi: 10.7759/cureus.41986. eCollection 2023 Jul.

Authors

Nasir A Magboul¹, Atheer A Alzubaidi², Lamya A Abumsmar³, Ali Alzarei³, Mohammad Al-Ahmari⁴, Mona A Alshehri⁴

Affiliations

¹ ENT, Armed Forces Hospital, Jazan, SAU.
² Otolaryngology - Head and Neck Surgery, Khamis Mushait General Hospital, Khamis Mushait, SAU.
³ Otolaryngology - Head and Neck Surgery, Aseer Central Hospital, Abha, SAU.
⁴ Otolaryngology, Aseer Central Hospital, Abha, SAU.

Abstract

Background: Paranasal sinus mucoceles are epithelium-lined cystic masses usually resulting from obstruction of sinus ostia. They most frequently occur in the frontal and ethmoid sinuses. The etiology is not clarified, but the most common identifiable cause of mucoceles following functional endoscopic sinus surgery (FESS), trauma, neoplasms, and allergy. The clinical symptoms of mucocele vary and are not specific, the most common being ophthalmic symptoms and headache, impinging on adjacent orbital structures, and causing ophthalmic sequelae such as double vision, commonly followed by orbital swelling, epiphora, proptosis, and ptosis. All patients in this study had frontal and frontoethmoidal mucocele and initially complained of frontal headache and ophthalmic symptoms. Definitive treatment options for paranasal sinus mucoceles include external approaches and endoscopic marsupialization. Objective: The study aimed to identify the etiology, clinical presentation, most common para nasal sinus affected by mucocele, management, and the rate of recurrence in eight cases with mucocele of the paranasal sinuses.

Methods: Eight patients diagnosed with mucocele of the paranasal sinuses were admitted to our institution between 2014 and 2021. There were two females and six males aged between 14 and 67. Initial symptoms, duration, clinical presentation upon admission, location of the mucocele, type of surgical intervention, and outcome have all been studied. Results: The most common symptoms at diagnosis were orbital involvement, retrobulbar, and frontal headache. Most patients were diagnosed with frontal mucocele (40%), and three were frontoethmoidal mucocele at the time of presentation. The rest of the cases were diagnosed with ethmoidal mucocele (25%). The etiology was identified in four patients and was unclear in the rest. All patients underwent endoscopic sinus surgery. The most identifiable postoperative complication was a headache.

Conclusions: The endonasal endoscopic approach is a safe and effective treatment for paranasal sinus mucocele and provides adequate drainage with a low recurrent rate.

Keywords: endoscopic approach; imaging study; mucocele; para-nasal sinus; saudi arabia.