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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Rivista Italiana di Chirurgia Maxillo-Facciale 2001 December;12(3):141-7
Pia F., Borello G., Policarpo M., Aluffi P.
From the Ear, Nose and Throat Clinic Faculty of Medicine and Surgery "Amedeo Avogadro" University of Eastern Piedmont, Novara
Background. Sinus mucoceles are a benign multifactorial disease that may cause severe complications. This retrospective study analyses a series of 41 patients aged 8 to 84 years (mean 46.6), affected by fronto-ethmoidal (56.1%), maxillary (34.1%), or sphenoidal (9.8%) mucocele. The most frequent etiology was post-surgery (36%).
Methods. Twenty five patients underwent a mixed surgical approach: open surgery plus functional endoscopic sinus surgery (FESS); 16 underwent endoscopic marsupialization. FESS has recently been introduced for routine treatment of fronto-ethmoidal, sphenoidal and maxillary mucoceles.
Results. Five complications occurred, 3 infective and 2 cicatricial. Two patients suffered a relapse. In 30/41 patients, follow-up ranged from 6 to 140 months (mean 4.3 years).
Conclusions. The role of FESS is becoming increasingly important in treating sinus mucoceles. FESS is contraindicated in far lateral frontal mucoceles, in cases of severe anatomic anomaly and/or marked fibrosis or ossification of the naso-frontal duct. In these cases open surgery with repermeabilization of the naso-frontal duct is recommended. Open surgery with sinus obliteration is mandatory in cases of severe infective complications (osteomyelitis, meningitis) and CSF leaks.