Mucoceles of the Paranasal Sinuses with Intracranial and Intraorbital Extension

Abstract

Twenty-eight patients received surgical treatment for a paranasal sinus mucocele with intracranial and/or intraorbital extension. The lesions were classified by site and extension: anterior without intracranial extension (Type 1), 7 patients; anterior with intracranial extension (Type 2), 11 patients; posterior midline without intracranial extension (Type 3), 5 patients; and posterior with intracranial extension (Type 4), 5 patients. The surgical approaches were: transnaso-orbital, transfrontonaso-orbital, transsphenoidal, transmaxillosphenoidal, and subfrontal transbasal; the choice depended on the site and extension of the lesion, with the aim of securing maximum exposure to ensure total removal of the lesion with its capsule. A transcranial approach was reserved for mucoceles possessing an intracranial extension or causing distension of the bone structures with optic pathway neurological symptoms. With a coronal or transfacial skin incision along the lines of the forehead, nose, and orbital muscles of expression and careful reconstruction, the patients' natural cast of features was spared or restored in a single operation.

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

“…26 The enlarging mass produces a progressive distension of the bony walls until there is compression of orbital and neural structures. 30 Such patients typically present with headache, proptosis, diplopia, nasal congestion, and fluid leakage. [38][39][40] Although mucocele formation is considered a late complication, its timing may be variable depending on the underlying etiology.…”

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

“…An associated mucocoele will appear as an isodense, non-enhancing mass [9,19] although the rare occurrence of an isodense, CSF-like lesion [28] and enhancing mucopyocoele [25,30], has been reported. At MRI, the high signal in T2-weighted sequences [27,30] is lost when secretions are dehydrated, suggesting a pneumatic cavity [25,27].…”

Intraorbital Mucocele Associated With Old Minor Trauma-Case Report-

“…2,4) The most common cause for mucocele is chronic sinusitis. 5) Obstruction of the nasosinus duct due to chronic sinusitis can result in mucocele formation.…”