Outcomes in Surgical Treatment of Mucocele in Frontal Sinus

Abstract

The aim of the study was to correlate several studies dating from 1997 to 2015 to identify the most effective treatments for mucocele in the frontal sinus (with/without other paranasal sinuses), considering successful outcomes and recurrence. We aimed to conduct a literature review for articles published between 1997 and 2015. For this, we accessed articles in the SciELO database, as well as LILACS, PubMed, and Google Scholar databases. Were identified 32 work-related injuries in the paranasal sinuses; 2 of these were not related to mucoceles or mucopyocele, 4 had no relation to the frontal sinus, 9 were related to the frontal sinus and other paranasal sinuses, 4 were related to mucocele associated with other sinuses, and 13 involved only the frontal sinus. Endoscopic techniques decrease intra- and postoperative morbidity, reducing the operative time, allow a larger view of the lesion and surrounding anatomical structures, and decrease chances of recurrence. Thus, the successful outcomes have been beneficial to both the surgeon and the patient.

Post-Radiation Sphenoidal Mucocele in a Patient Treated for Nasopharyngeal Cancer

“…5,7,8 Mucoceles can cause various signs and symptoms, depending on the affected area; those symptoms can be rhinological, ophthalmic or neurological. 10 Imaging is essential for the diagnosis and management of paranasal sinusmucoceles, it is based on computerized tomography (CT) scan and MRI. 11,12 On CT-scan, mucoceles can be hypodense, isodense or hyperdense with peripheral enhancement after injection of contrast agents, bone erosion can be found.…”

When is a multidisciplinary approach required in management of intracranial complications of sinonasal inflammatory disorders?

“…It decreases intra and postoperative morbidity, reducing the operative time, allows a larger view of the lesion and surrounding anatomical structures, reduces chances of recurrence but the success rate is strictly linked to the experience of the surgeon. Another approach found in literature is the combined technique (external approach and endoscopy), which can be used in selected and more complicated cases 26 , depending on the extension of mucoceles and of its intracranial complications. In case of infections (mucopyoceles and meningitis) it is also necessary to administrate antibiotic therapy (in Figure 6 we propose a practical algorithm of management of intracranial complications of mucoceles).…”

“…Extensive AFRS with intracranial complications are still relatively rare 34 . The gold standard of IFRS treatment is surgical debridement and systemic empiric antifungal therapy until the causative fungal species is identified 31,36,38 ; the most used are amphotericine and voriconazole 26 . The angioinvasion, thrombosis and resulting tissue necrosis make it difficult for chemotherapeutic agents to penetrate the ischemic tissues, that's why surgical debridement of infected and necrotic tissue is considered an essential component of an optimal management 39 (Tab.…”

Mucocele de cavidades paranasales

“…Además, el abordaje endoscópico facilita el examen endoscópico de la cavidad paranasal comprometida. El seno frontal es el que más limitaciones quirúrgicas podría llegar a presentar para realizar una cirugía completamente endoscópica, principalmente en mucoceles muy lateralizados, cuando hay abundante fibrosis o anatomía desfavorable, debiendo considerar caso a caso el abordaje [21][22][23] . La recurrencia de los mucoceles tratados con cirugía endoscópica funcional varía entre las di-ferentes series, siendo de 0,9% a 8,9% a 4 años de seguimiento 24 .…”