Endoscopic sinus surgery for maxillary sinus mucoceles

Between 2003 and 2005, 14 patients underwent endoscopic sinus surgery for maxillary sinus mucocele. The presenting sign and symptoms, radiological findings, surgical management and need for revision surgery were reviewed.There were eight males and six females with an age range of 14 to 65. Ten patients complained of nasal obstruction, five of nasal drainage, five of cheek pressure or pain and one of proptosis of the eye and cheek swelling. The maxillary sinus and ipsilateral ethmoid sinus involvement on computed tomographic studies was seen in 4 patients. Four patients had history of endoscopic ethmoidectomy surgery for ethmoid sinusitis and one had Caldwell-Luc operation in the past. Ethmoidectomy with middle meatal antrostomy and marsupialization of the mucocele was performed in all patients. Postoperative follow-up ranged between 8 to 48 months. All patients had a patent middle meatal antrostomy and healthy maxillary sinus mucosa. No patients need revision surgery.The most common causes of mucoceles are chronic infection, allergic sinonasal disease, trauma and previous surgery. In 64% of the patients of our study cause remains uncertain. Endoscopic sinus surgery is an effective treatment for maxillary sinus mucoceles with a favorable long-term outcome.Mucoceles are benign, locally expansile paranasal sinus masses. They are cyst-like structures lined by the mucoperiosteum of the involved sinus [1,2]. Mucoceles are most commonly found in the frontal sinus, with the ethmoid and sphenoid sinuses involved less frequently. Maxillary sinus mucoceles are relatively rare, accounting for 10% or less of all paranasal sinus mucoceles described in the United States or Europe. However, it is more commonly reported in Japan, usually as a long term sequel of Caldwell-Luc surgery [3,4].Mucoceles are believed to form following obstruction of the sinus ostia, with accumulation of fluid within a mucoperiosteal lined cavity. As mucus continued to be produced within the mucocele, it e