Frontal-Orbital-Ethmoid Mucoceles

Campbell, Raewyn; Kamat, Ameet; Schipor, Ioana; Palmer, James N.

doi:10.1007/978-3-662-48523-1_13

Cited by 4 publications

(11 citation statements)

References 38 publications

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“…Thus, absent agger and poorly pneumatized ethmoid bullae in this patient led to prominent LSGs and supra-orbital cells that communicated with frontal recesses. Besides the intrinsic expansile nature mediated by osteolytic cytokines and enzymes, a long-standing frontal-orbital-ethmoid mucocele takes advantage of the absence of resistance otherwise put up by the bony septae, and encroaches unhindered through communicating air spaces, gradually expanding, distorting, and remodeling them [2]. Therefore, careful study of ethmoid pneumatization before surgery can predict the mucocele's extent so that a complete and wide marsupialization can be planned.…”

Section: Clinical Details and Imaging Studymentioning

confidence: 99%

“…Within the anatomic domain of nose and paranasal sinuses, mucoceles are relatively common, because the area is lined by respiratory (ciliated pseudostratified columnar) epithelium that is rich in goblet cells. They mostly involve the fronto-ethmoid region, and less commonly the sphenoid, and results from blockage of the sinus ostia [1], [2]. Most of them are idiopathic, or occur in the setting of chronic rhinosinusitis and allergy, but they might also result as a long-term sequela of local trauma, including endoscopic sinus surgery of the frontal recess area [1], [2].…”

Section: Introductionmentioning

confidence: 99%

“…They mostly involve the fronto-ethmoid region, and less commonly the sphenoid, and results from blockage of the sinus ostia [1], [2]. Most of them are idiopathic, or occur in the setting of chronic rhinosinusitis and allergy, but they might also result as a long-term sequela of local trauma, including endoscopic sinus surgery of the frontal recess area [1], [2]. It is a slow-growing, expansile space-occupying lesion that can be left untreated, with watchful observation, unless they are symptomatic.…”

Section: Introductionmentioning

confidence: 99%

“…It is a slow-growing, expansile space-occupying lesion that can be left untreated, with watchful observation, unless they are symptomatic. However, they often assume large dimensions and cause pressure effects with bone remodeling based on an array of inflammatory mediators [2]. Adjacent structures like the orbital roof, the eyeball, lamina papyracea, frontal sinus tables, and anterior skull base might be affected leading to insidious symptoms (headache, orbital pain), significant disfigurement, intracranial extension, and an overall impairment of the quality of life, necessitating surgical intervention [1], [2], [3].…”

Section: Introductionmentioning

confidence: 99%

“…The extent of involvement by a slowly expanding mucocele is quite unpredictable and is dependent on the available communications through the ethmoid labyrinthine septae and pattern of ethmoid pneumatization. Therefore, the role of imaging, especially that of high-resolution computed tomography (CT) scan of the nose and paranasal sinuses, along with diagnostic nasal endoscopy, is essential prior to embarking on endoscopic surgery, which is the principal mode of present-day surgical intervention [2], [3]. A large mucocele (or a mucopyocele) obscures the major surgical landmarks that are keys to a successful and complete endoscopic procedure, and distorts vital anatomic structures (like the anterior ethmoid artery [AEA], lamina papyracea, etc.…”

Section: Introductionmentioning

confidence: 99%

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Ethmoid pneumatization and a large frontal-orbital-ethmoid mucocele

Dutta

2019

Radiology Case Reports

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Frontal-orbital-ethmoid mucocele is a slow-growing retention cyst of the fronto-ethmoid complex secondary to blockage of the sinus ostia. It may produce significant disfigurement of the periorbital region necessitating surgical intervention. Prior to surgery, it is imperative to study the mucocele's extent through the variable patterns of ethmoid pneumatization as evident from clinical, imaging (computed tomogram) and endoscopic evaluation. This is illustrated in a case study of a 41-year-old woman presenting with fullness below the right eyebrow, progressive proptosis, and gaze restriction. The provisional diagnosis of frontal-orbital-ethmoid muco(pyo)cele was confirmed at endoscopic surgery, when it was drained and marsupialized through ethmoidectomy and frontal sinusotomy. Understanding the relationship of an enlarging mucocele with the inconsistent pattern of ethmoid pneumatization is the primary determinant for an uneventful and complete surgery, and to minimize recurrence. The gradually expanding mucocele occupies the path of least resistance and encroaches into the available spaces of ethmoid labyrinth, distorting key anatomic landmarks and making surgical intervention potentially challenging. Thus, preoperative imaging corroborated with naso-endoscopy is of paramount importance to trace the lesion along ethmoid pneumatization, and determine the relative positions of structures vulnerable to surgery. This often requires a comparative study of the contralateral side because the mucocele generally obscures the pneumatization pattern and vital landmarks on its side. The present imaging tutorial studies the extent of a large frontal-orbital-ethmoid mucocele through interpretation of multiplanar computed tomography cuts, keeping in mind the unpredictable nature of its expansion as a function of the highly individualistic ethmoid pneumatization.

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Section: Clinical Details and Imaging Studymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Ethmoid pneumatization and a large frontal-orbital-ethmoid mucocele

Dutta

2019

Radiology Case Reports

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The axillary flap/trans‐agger approach as a supero‐lateral conduit to the effective frontal recess for marsupialisation of fronto‐ethmoid mucocele

Dutta

Azgaonkar

2021

Clinical Otolaryngology

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Longstanding giant frontoethmoidal mucocele with orbital and intracranial extension: challenges of surgical approach in a developing nation

Aliyu

Adeyeye

Mohammed

et al. 2023

Int J Otorhinolaryngol Head Neck Surg

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Mucoceles of the paranasal sinuses are expansile, benign mucus filled epithelial lined cystic-like lesion resulting from chronic obstruction to sinus ostia. They erode bony walls by pressure and bony resorption with the frontal and ethmoid sinuses predominately affected. The expansile lesion can involve surrounding structures like the orbit, intracranium or nasopharynx. Diagnosis is based on history, examination and radiological assessment with Computerized tomography scan being the imaging of choice. Surgery is the mainstay of treatment and would require collaboration with the neurosurgeons or the ophthalmologist when it extends to the brain or orbit respectively. It can be done via an external approach, endoscopic approach or a combination of both. If left without intervention, it may cause morbidity and potential mortality due to its proximity to the brain and orbit. We report a rare case in our setting of a 65-year-old male farmer with a painless huge left sided cystic fronto-orbital swelling of 8 years that mimicked a benign orbital tumor. The mass was non-tender and not pulsatile measuring about 20×18 cm with normal visual acuity. Computed tomography (CT) scans of the brain and paranasal sinus revealed a large well-defined non-contrast enhancing homogenous lesion involving the left fronto-ethmoidal sinuses with orbital and intracranial extension as well as inferolateral displacement of the left eye globe. He was reviewed by the ENT surgeons, neurosurgeons and ophthalmologists and subsequently had frontoethmoidectomy via an external approach.

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Frontal-Orbital-Ethmoid Mucoceles

Cited by 4 publications

References 38 publications

Ethmoid pneumatization and a large frontal-orbital-ethmoid mucocele

Ethmoid pneumatization and a large frontal-orbital-ethmoid mucocele

The axillary flap/trans‐agger approach as a supero‐lateral conduit to the effective frontal recess for marsupialisation of fronto‐ethmoid mucocele

Longstanding giant frontoethmoidal mucocele with orbital and intracranial extension: challenges of surgical approach in a developing nation

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