Orbital İnvazyon Gösteren Paranazal Sinüs Mukoselleri

Abstract

The aim of this study was to report the clinical features, management, and outcome of patients with paranasal sinus mucocele with intraorbital extension. Ma te ri als and Met hods: Eleven patients who were diagnosed and treated for paranasal sinus mucocele with intraorbital extension between 2005-2012 were included in this retrospective study. The clinical characteristics, treatment modalities, and complications were recorded and analyzed. Re sults: The records of 11 patients (aged 25 to 69, mean 47.6±15.6 years) with orbital mucocele were included in this study. The most frequent initial symptoms and findings were proptosis in 7 patients (63.6%), diplopia in 6 patients (54.5%), and ocular movement limitation in 6 patients (54.5%). The origin of the orbital mucocele was frontal sinus in 6 patients (54.5%), ethmoidal sinus in 3 patients (27.3%), and maxillary sinus in 2 patients (18.2%). Eight patients whose mucoceles were approachable with endoscopy (72.7%) were treated with functional endoscopic sinus surgery (ESS) and marsupialization of the sinus to the nasal cavity. Three patients' mucoceles (27.3%) were located in the lateral side of the frontal sinus and were unapproachable with endoscopy. In these patients, the endoscopic approach was combined with the osteoplastic flap technique by external approach. After surgery, all the patients' findings and symptoms improved; only one patient who had recurrent bilateral mucoceles required additional surgery. This recurrence was regressed by endoscopic surgery and no additional complications were observed. Conclusion: The frontal and ethmoidal sinuses were the most common origin of orbital mucoceles. Proptosis, limitation of eye movements, and diplopia were the most frequently detected signs in patients with orbital mucocele. Endoscopic sinus surgery produced favorable results in patients with an endoscopically approachable mucocele, and the osteoplastic flap technique with external approach led to successful results in patients with endoscopically unapproachable mucoceles.