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Pediatric paranasal sinus mucoceles: etiologic factors, management and outcome
R Nicollas1, F Facon, I Sudre-Levillain
1Department of Pediatric Otolaryngology Head and Neck Surgery, La Timone Children's Hospital, 264 Rue Saint Pierre, 13385 Marseille Cedex 05, France. richard.nicollas@ap-hm.fr
Insights
Pediatric paranasal sinus mucoceles are rare but often linked to cystic fibrosis. Endoscopic surgery is effective, with no recurrences or complications observed in this study.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Medical Imaging
Background:
- Paranasal sinus mucoceles are uncommon cystic masses in children.
- Identifying etiological factors is crucial for understanding disease progression.
Purpose of the Study:
- To investigate local and general causes of pediatric paranasal sinus mucoceles.
- To evaluate the effectiveness of endonasal marsupialization for treatment.
Main Methods:
- Retrospective analysis of 10 pediatric cases.
- Utilized CT-scan and MRI for imaging.
- All patients underwent endoscopic surgical procedures.
Main Results:
- Cystic fibrosis identified in 60% of cases.
- Trauma and inflammation were other contributing factors.
- 30% of patients had ophthalmologic issues, resolved post-surgery.
Conclusions:
- Predisposing factors, particularly cystic fibrosis, were present in 90% of cases.
- CT and MRI aid in differentiating mucoceles from other tumors.
- Endoscopic endonasal surgery is the preferred treatment for pediatric paranasal sinus mucoceles.
Objectives:
To study the local and general etiological factors of paranasal sinus mucoceles in the pediatric population and to evaluate and discuss the clinical management and the results of endonasal marsupialization.
Design:
Retrospective study.
Patients And Methods:
A series of 10 cases of paranasal sinus mucocele in children were managed. For imaging, CT-scan and, sometimes MRI were performed. An ophthalmologic evaluation was performed preoperatively in all cases, and post-operatively in case of preoperative trouble. All patients were treated with endoscopic surgical procedure. Authors also looked for etiological factors.
Results:
Cystic fibrosis was found in 6 cases out of 10. Others etiological factors were trauma and inflammatory process; one case was strictly idiopathic. Three patients out of 10 had ophthalmologic trouble related with the mucocele. With a mean follow-up of 17 months, neither recurrence nor complication were noted. All patients with ophthalmologic complain were free of trouble after surgery.
Conclusion:
Paranasal sinus mucoceles in children are still rare. In our experience, 9 out of 10 patients had predisposing factors, especially cystic fibrosis. Imaging with CT-scan and MRI allow the physician to rule out other tumors such as meningoceles or rhabdomyosarcoma. Endoscopic endonasal surgery is nowadays the gold standard for the treatment of paranasal sinus mucoceles.
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