The Pressure Exerted by Mucoceles in the Frontal Sinus: An Experimental Study in the Cat

Abstract

The pathophysiologic process that results in bone erosion from frontal sinus mucoceles has long been a mystery. Traditionally, bone erosion has been attributed to pressure. However, no scientific evidence has yet been presented to support this hypothesis. To answer this question, seven cats had a mucocele created in one frontal sinus, with the other sinus left as a control. A manometer was inserted into each frontal sinus. Pressure readings were taken over a 7-month period. Pressures on the mucocele side were higher than on the control side and were sufficient to erode bone. Bone was thicker on the mucocele side than on the control side. This study established that mucoceles exert sufficient pressure to erode bone, and that such erosion may be part of a two-stage process.

Life threatening intracranial complications of frontal sinus osteomas: Report of two cases

“…Frontal sinus osteomas and mucocoeles are associated in 16% of cases, however, only rarely is the pressure exerted by secretions sufficient to determine delayed erosion of sinus walls [12], meningeal layers and brain parenchyma, as we observed.…”

Manometric Study of Paranasal Sinus Mucoceles

“…8 -9 Static pressure within mucoceles has not been measured in humans; however, positive pressure has been measured within experimentally induced mucoceles in a feline model. 11 Pressure measurements in 4 cats averaged +17.1 cm H2O. 11 In the present study, static pressure measurements were taken in 3 adults with spontaneously occurring paranasal sinus mucoceles.…”

“…11 Pressure measurements in 4 cats averaged +17.1 cm H2O. 11 In the present study, static pressure measurements were taken in 3 adults with spontaneously occurring paranasal sinus mucoceles.…”

Frontal Recess Mucocele Associated with Osteoma: Case Report

“…In case of the association of paranasal sinus mucocele and osteoma, osteoma is considered to cause the mucocele by occlusion of the sinus ostium. Fenton et al (9) induced mucocele formation in a feline model in experimental conditions. Maturo et al (10) demonstrated the frontal sinus mucocele formation in a goat model, induced by a long-term frontal recess obstruction by frontalis muscle plugging.…”