Journal of Surgery
IntroductionSinus mucoceles are true cysts lined by pseudostratified respiratory epithelium and have a mucous or mucopurulent content [1]. They are produced by the accumulation of mucous secretions within tissue or the sinus cavity, secondary to obstruction of the sinus ostea (obstructive type). By definition, if there is partial obstruction of ducts of seromucous glands within the sinus wall, such true cysts are called retention cysts of the maxillary sinus. While retention cysts are typically asymptomatic and incidental findings, the obstructive type sinus mucocele is capable of significant expansion and destruction [2]. Chemical mediators, such as prostaglandin E2 and collagenase, are released at the capsule of the mucocele, possibly causing bony destruction and allowing the mucocele to expand into adjacent structures [3]. They can lead to exophthalmos, limited eye movement and headaches in patients. Rarely, ethmoid sinus involvement may induce oculomotor nerve paralysis. The frontal sinus is most commonly affected, whereas involvement of sphenoid, ethmoid, and maxillary sinuses are unusual sites of involvement [4]. We present a case of obstructive type sinus mucocele of the left maxillary sinus in an 18 year old female.
Case ReportAn 18 year old Cambodian female presented to Children's Surgical Center at the National Rehabilitation Center in Phnom Penh, Cambodia for evaluation of left maxillary sinus swelling and discomfort (Figure 1). In addition to notable facial asymmetry, the enlargement was associated with elevation of the left orbit. No visual disturbances, however, were noted. A computerized tomography (CT) scan without contrast was ordered and showed a cystic process of the left maxillary sinus ( Figure 2) and treatment was planned for February 2014. An 18-guage needle was chosen for aspiration through an existing bony defect apical to teeth 12-14, returning a mucoid material. Subsequent surgical access was gained in the same area and, upon entry into the sinus, the membrane appeared normal. The lumen of the sinus was entirely filled with a gray, viscous, mucoid material. This, along with a portion of the sinus lining, was removed and submitted for histopathologic examination. An antrostomy of the sinus was completed prior to closure. Recovery and healing were uneventful.
AbstractObjective: Sinus mucoceles are true cysts that develop secondary to obstruction of sinus ostea and can be associated with significant morbidity. Study Design. We present a case of obstructive-type sinus mucocele of the maxillary sinus, including clinical, radiographic, histologic findings, as well as treatment.Results: An 18 year old female presented for evaluation and management of maxillary sinus swelling. A diagnosis of sinus mucocele was rendered after clinical, radiographic, surgical and histopathologic examinations. Recurrence developed within four months of the initial surgical intervention.
Conclusions:Sinus mucoceles may be associated with significant morbidity and are currently managed most oft...
