Paranasal Sinus Mucoceles with Ophthalmologic Manifestations: A 17-year Review of 96 Cases

Kim, Yoo Suk; Kim, Kyubo; Lee, Jeung Gweon; Yoon, Joo Heon; Kim, Chang Hoon

doi:10.2500/ajra.2011.25.3624

Cited by 61 publications

(67 citation statements)

References 20 publications

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“…2 Axial MR imaging of the brain with T1WI (a), T2WI (b), and contrast-enhanced T1WI (c) demonstrating an ethmoid mucocele causing mass effect on optic nerve and medial rectus include the third, fourth, fifth, and sixth cranial nerves and, rarely, the pituitary. Sphenoidal mucoceles are also more commonly associated with headaches [1,7,8].…”

Section: Discussionmentioning

confidence: 99%

“…Symptoms vary depending on the location of the mucocele and may be classified as rhinological, neurologic, or most frequently ophthalmologic [5,7]. In general, fronto-ethmoidal involvement causes mass effect upon the orbit leading to proptosis, hypophthalmos, diplopia, and periorbital swelling.…”

Section: Discussionmentioning

confidence: 99%

“…Secondary causes most commonly result from previous sinus surgery or facial trauma. Other predisposing factors include cranial dysplasias, chronic sinusitis, and sinonasal manifestations of systemic disease [3,4,7]. In cystic fibrosis, 16 % of patients with chronic rhinosinusits also have mucoceles [3].…”

Section: Discussionmentioning

confidence: 99%

“…Surgical excision is the treatment of choice and early intervention is indicated to prevent visual compromise or in cases of pyelocele [1,7]. Historically, mucoceles have been removed through external approaches, such as a LynchHowarth incision, Caldwell-Luc approach, or an osteoplastic flap.…”

Section: Discussionmentioning

confidence: 99%

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Paranasal Sinus Mucocele

Capra

Carbone

Mullin

2012

Head and Neck Pathol

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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. While ophthalmologic symptoms are most common, patients also report rhinological or neurological complaints. The close proximity of paranasal sinus mucoceles to the orbit and skull base predisposes the patient to significant morbidity. Computed tomography displays a non-enhancing homogenous mass with expansion of bony walls. Magnetic resonance imaging reveals variable intensity of T1-weighted images and a hyperintense mass on T2-weighted images. Histopathologically mucoceles have features of respiratory mucosa with areas of reactive bone formation, hemorrhage, fibrosis, and granulation tissue. Surgical excision is the standard treatment with trends towards endoscopic techniques.Keywords Paranasal sinus mucocele Á Magnetic resonance Á Computed tomography Á Blindness Á Ophthalmologic Á Optic neuropathy Á Cranial neuropathy Á Osteolysis Á Inflammatory infiltrate HistoryA 54-year-old female with a history of cataracts was referred by an ophthalmologist to the Otolaryngology Clinic for acute worsening of visual acuity and diplopia in the right eye. Symptoms began 5 months prior and were described as a 'white curtain' in her vision. Her ophthalmologic exam showed proptosis and chemosis of the eye and her visual acuity ipsilaterally was 20/100 (baseline 20/25). The optic disc was pink and healthy on exam. Cranial nerves III, IV, V, and VI were intact, with only minimal impairment of extraocular muscle movement. Radiographic FeaturesA non-contrast computerized tomographic (CT) scan of the head and orbits showed a 4.4 cm 9 4.2 cm 9 3.3 cm well-circumscribed expansile mass in the right ethmoid sinus. The medial orbital wall was expanded with evidence of mass effect upon the medial rectus muscle and optic nerve (Fig. 1). Nuclear magnetic resonance images (MRI) of the head with and without contrast demonstrated a hyperintense mass on T2-weighted images (WI) and a hypointensity on T1WI. The MR fluid attenuation inversion recovery (FLAIR) sequence suggested proteinaceous fluid (Fig. 2). TreatmentThe mass was emergently decompressed through an endoscopic approach in the operating room. Resistance to retropulsion of the right eye resolved immediately and the patient's visual acuity returned to baseline within 24-h of surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Paranasal Sinus Mucocele

Capra

Carbone

Mullin

2012

Head and Neck Pathol

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“…It allows to differentiate and to assess any extension into the orbit or intracranial compartment, but, unfortunately it can't study bone detail. 14,15 Its indications are in complement of the CT scan in case of diagnosis doubt in CT scan between mucocele and other tumors or inflammatory lesions, in case of sphenoid location and in endocranial or orbital extension.…”

mentioning

confidence: 99%

Imaging of Paranasal Sinus Mucoceles

Marrakchi¹,

Nefzaoui²,

Chiboub³

et al. 2016

Otolaryngol Open J

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Introduction: Mucoceles are cystic masses developing after obstruction of the sinus ostium. The symptoms are not specific. Computed Tomography scan (CT scan) and Magnetic Resonance Imaging (MRI) confirm the diagnosis. Objectives: We herein review the radiologic characteristics of mucoceles in CT scan and MRI. Materials and Methods: We report a retrospective study of 43 patients diagnosed with paranasal sinuses mucoceles. CT scans were performed for all patients, but MRI was carried out only in selected cases. Results: Our study was constituted of 27 males and 16 females with a mean age of 47 years. The CT scan appearence of mucoceles were in all cases as a well circumscribed expansile sinus mass with an effect on the neighbor bone structure. This mass was hypodense in 26 cases, isodense in 14 cases and hyperdense in 3 patients. The paranasal sinuses most frequently affected in our series were the fronto-ethmoidal sinuses. The most affected bone eroded was the lamina papiracea. Intracranial extension was seen in four cases. CT scan allowed to predict the cause of mucoceles in some cases and to provide information about anatomic variants. MRI was realized for 15 patients in addition to the CT scan. It allowed to study the extension of mucoceles to the neighboring organs especially orbital and endocranial ones. Conclusion: The presentations of mucoceles on imaging are quite variable. CT scan provides precious information about the location, bone erosion and extension of the mucoceles. MRI is indicated in some cases especially in cases of orbital or cranial extension.

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