Mucocele frontoetmoidal: relato de casos e revisão da literatura

Abstract

As mucoceles dos seios paranasais são lesões císticas de revestimento epitelial com conteúdo mucóide, que apresentam crescimento lento com características expansivas e de reabsorção óssea. Eventualmente, podem comprometer as estruturas nobres adjacentes como a órbita e a cavidade intracraniana. Acredita-se que sua etiologia esteja ligada à obstrução do óstio de drenagem do seio paranasal envolvido. Podem causar dor facial, cefaléia, obstrução nasal, diplopia, diminuição da acuidade visual, deslocamento do globo ocular, edema facial ou até mesmo meningite, dependendo da área anatômica comprometida. Acomete mais freqüentemente os seios frontal e etmoidal anterior, sem prevalência de sexo. O diagnóstico é realizado através de exames de imagem, sendo a tomografia computadorizada o exame de eleição, embora em algumas ocasiões a ressonância magnética esteja indicada. Atualmente a abordagem endoscópica paranasal é o acesso cirúrgico de primeira escolha, por ser menos invasiva e apresentar menor morbidade. Este estudo relata dois casos de mucocele frontoetmoidal com extensão orbitária, abordados por via endoscópica endonasal. Os resultados comprovaram a segurança e eficiência deste acesso cirúrgico.

Mucocele maxilar em lactente de 4 meses de idade

“…1 CT is the exam of choice for the diagnosis of mucoceles; it not only demonstrates sinus involvement, but also provides information about bone erosion and other effects on neighboring structures. 4,5 In this case, the mucocele was in the right maxillary sinus, it eroded the medial wall and invaded the nasal cavity, which explained the nasal block. Although maxillary sinus mucoceles are associated with prior surgery and -in children -with cystic fibrosis, the patient had none of these two factors.…”

“…4 Outpatient follow-up is mandatory to promptly identify recurrences. 5 This patient is being monitored carefully, and has progressed favorably until now.…”

Maxillary mucocele in a 4-month infant

“…CT is the exam of choice for the diagnosis of mucoceles; it not only demonstrates sinus involvement, but also provides information about bone erosion and other effects on neighboring structures. 4 , 5 …”

“…Outpatient follow-up is mandatory to promptly identify recurrences. 5 This patient is being monitored carefully, and has progressed favorably until now.…”

Anatomical variations and abnormalities of the maxillary region and clinical implications: A systematic review and metaanalysis

“…Knowing the possible anatomical variations that could be found within the MS, helps clinicians when making decisions regarding diagnosis, prognosis, and the development of a treatment plan for their patients. [15][16][17][18] Extensive reports of the MS suggest that various clinical complications of the surrounding structures may be associated with the MS. For example, ample evidence, found in recent scientific literature, shows that dental sepsis commonly results in reactive mucosal thickening on the lower face of the MS. [19] The hyperneumatization of the Maxillary Alveolar Processes is an odontogenic cause of maxillary sinusitis, a disease that affects the anterior Paranasal Sinuses, that is currently increasing in incidence, being more common than it had been previously thought. [20] Opacification and sinusitis in the MS, which affects a group of the unilateral anterior sinus, in 75% and 25% to 40% of cases, respectively, have a dental etiology.…”