Mucocele after transnasal endoscopic repair of traumatic anterior skull base fistula in children

Assessment of Mucocele Formation after Endoscopic Nasoseptal Flap Reconstruction of Skull Base Defects

“…Postoperative mucocele formation after endoscopic sinus surgery has been reported with average time lapse between 2 and 6 years. 26,39,[41][42][43] Nonetheless, prior reports of mucocele formation after vascularized PNSF repair have been reported at 46 days 31 and at 4 months. 32 Different ideologies exist for the pathogenesis of mucocele formation, because there are a variety of etiologies that lead to sinus obstruction.…”

“…27,46 In addition, avoiding trauma of the healthy mucosa surrounding the middle meatus and extensive cleansing of the ethmoid cavity might decrease the risk of adhesions and development of mucocele. 26 Another recommendation is to avoid the overlapping of flaps when using bilateral PNSF, because it may predispose to mucocele formation due to the mucosal entrapment mechanism. 34 Verilaud et al 26 evaluated the formation of mucoceles after endoscopic repair of CSF fistulas in children with autologous free grafts, most commonly with the middle turbinate.…”

“…26 Another recommendation is to avoid the overlapping of flaps when using bilateral PNSF, because it may predispose to mucocele formation due to the mucosal entrapment mechanism. 34 Verilaud et al 26 evaluated the formation of mucoceles after endoscopic repair of CSF fistulas in children with autologous free grafts, most commonly with the middle turbinate. Mucocele development occurred in 50% of their cases in their 12 patient series suggesting that the frequency may be higher in the pediatric population.…”

“…9 -24 A potential risk after reconstruction of SB defects is mucocele formation. [25][26][27][28] A sinonasal mucocele is a mucus-containing sac lined with epithelium that forms secondary to obstructed sinus drainage after previous sinus surgeries, posttraumatic lesions, chronic sinusitis, tumors, and infectious and inflammatory processes. 29 Although benign, mucoceles may produce a growing mass with the potential to erode bone and adjacent orbital and neural structures, making their removal imperative.…”

“…30 Postoperative mucocele formation after endoscopic SB reconstruction has previously been reported. 35,26 Bleier et al 31 reported a 3.6% mucocele rate after SB defect repair using the vascularized PNSF. Vaezeafshar et al 32 also reported a mucocele 4 months after SB reconstruction with a vascularized PNSF.…”