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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
Rivista di Chirurgia Maxillo-Facciale
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2008 August;19(2):79-87
Giant mucocele of the frontal sinus involving the anterior skull base or the orbital cavity: our experience
Sassano P., Agrillo A., Mustazza M. C., Verdino G., Iannetti G.
Department of Maxillo Facial Surgery Polyclinic Umberto I “La Sapienza” University, Rome, Italy
Aim. Mucoceles occur as a result of slow accumulation and retention of mucous secretions in the paranasal sinus. The exact etiology of this pathology is unknown. Most mucoceles arise from the frontal or the ethmoid sinus or both. Giant frontal mucoceles can extend to the anterior skull base or the orbital cavity and lead to a supero-medial canthal region with palpable mass or exophthalmos. Diagnosis is based on clinical investigation cunducted with the aid of traditional radiographs, computed tomography scans and magnetic resonance imaging if necessary. The aim of this study was to describe our experience with 31 patients affected by this pathology.
Methods. Thirty-one patients were selected retrospectively for the study. All the patients underwent open surgery treatment.
Results. The immediate postoperative period was normal for 25 patients. Six patients had transient cerebrospinal fluid (CSF) rhinorrhea, that was managed conservatively with lumbar CSF drainage and acetazolamide and resolved in four days. During the follow-up period all the patients had excellent cosmetic and functional recovery with complete resolution of the pre-surgical clinical symptoms.
Conclusion. No agreement concerning the best therapeutic approach to giant frontal mucoceles is in the Literature. However open surgery seems to be the best procedure to approach giant frontal mucoceles involving the orbital cavity or the anterior skull base.