Vivar AE, Uriarte CTC

Language: Spanish
References: 17
Page: 50-59
PDF size: 508.60 Kb.

ABSTRACT

Background
Mucoceles of the paranasal sinuses are cystic lesions with ciliated pseudostratified columnar epithelium containing mucus, generally sterile. They are caused by a sinus ostial obstruction, which is trapped in the secretory epithelium and continues segregating yellowish mucus. Mucoceles grow slowly and gradually, pressing the tissues surrounding bone, which erodes or alters the bone wall; sometimes, they extend to the orbit, the nasopharynx and the cranial cavity.
Objective
To assess factors that may cause mucocele in the sinuses.
Material and methods
We made a cross-sectional, descriptive, observational and retrospective study that included 30 patients diagnosed with mucocele of the sinuses at Centro Médico Nacional Siglo XXI, from January 1, 2001 to December 31, 2005. Location and extent of mucocele were considered dependent variables, and independent variables were age and sex of the patient. Patients whose diagnosis had been made over five years earlier, those that did not have clinical files or laboratory and clinical tests, and those that had received a differential diagnosis as chronic rhinosinusitis, polyps, cysts retention, benign and malignant tumors of nose and sinuses, were excluded.
Results
Of the 30 patients (14 men and 16 women) selected were excluded three (two men and one woman) because they did not have clinical files or laboratory and clinical tests. In total, 27 subjects were analyzed, 12 men (44%) and 15 women (56%). Of these, seven patients (26%) had frontal sinus mucocele; four patients (15%) had ethmoidal sinus mucocele; two (7%) sphenoidal mucocele; and five patients (19%) had mucocele of the jaw. Nine patients suffered this alteration in more than one sinus (fronto-ethmoidal, 33%); 14 (51%) had a history of chronic rhinosinusitis; five (19%) had rhinosinus surgery (two, Caldwell Luc procedure; two, resection of transsphenoidal pituitary adenoma and one patient functional endoscopic sinus and nose surgery) and eight patients (30%) had more than one etiologic factor. Twenty-two patients (81%) underwent endoscopic marsupialization; one patient (4%) underwent frontal osteoplastic operation; and the other four patients (15%) underwent a combined approach (two had a frontal osteoplastic with endoscopic marsupialization, and the other two had external frontoethmoidectomy (Lynch procedure) and endoscopic marsupialization.
Conclusions
Mucoceles of the paranasal sinuses affect at any people, regardless age or gender. They commonly develop in the frontoethmoidal region and are caused by several etiologic factors, such as: chronic rhinosinusitis (51% of cases), prior rhinosinus surgeries (19%) or a combination of diseases (30%), as chronic rhinosinusitis with polyps, chronic rhinosinusitis and allergic rhinitis, and allergic rhinitis and nasal polyposis. The most common etiologic factor in this population is infectious rhinosinus, either alone or with concomitant allergic and inflammatory factors.

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