Maxillary sinus mucoceles: Clinical presentation and long-term results of endoscopic surgical treatment

Objective: To describe the clinical presentation of maxillary sinus mucocel es, understand their pathogenesis, and determine the long-term efficacy of the endoscopic surgical treatment, Study Design: Retrospective review, Meth ods: Thirteen consecutive patients who presented with maxillary sinus muco( pyo) celes were studied. Subjects with history of preceding sinus/nasal sur gery or facial trauma were excluded, The presenting signs and symptoms, rad iological findings, and surgical management were reviewed, Results: There w ere six women and seven men with an age range of 31 to 71 years. Two patien ts had environmental allergies, Nine patients complained of cheek pressure, or pain, six of nasal obstruction, and eight of nasal drainage. On endosco pic nasal examination, the medial wall of maxillary sinus was bulging with prolapsed middle meatal mucosa in 10; drainage was seen in 7,but none had p olyps. The sinus involvement was limited to the maxillary sinus and the ips ilateral ethmoid on computed tomographic studies ill 10 cases, Patients wer e treated with endoscopic ethmoidectomy, middle meatal antrostomy, and mars upialization of the mucocele, Intraoperative cultures grew organisms in fiv e patients. Postoperative follow-up ranged between 10 and 66 months. Two pa tients required lysis of adhesions in the middle meatus, and one, revision antrostomy, All patients had a patent middle meatal antrostomy and healthy maxillary sinus mucosa at latest follow-up. The presenting symptoms resolve d or improved in 12 cases. Conclusions: The etiology of maxillary sinus muc oceles is not well understood. Mechanical obstruction or allergy or both do not seem to play an important role,An infectious origin is also not suppor ted by the above data. Endoscopic sinus surgery is a reliable therapeutic m easure with a favorable long-term outcome.