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Paediatric paranasal sinus mucoceles
H Olze1, C Matthias, P Degenhardt
1ENT-Department, Medical Centre Charité, Campus Virchow Klinikum, Berlin, Germany. heidi.olze@charite.de
Insights
Paranasal sinus mucoceles are rare in children, often presenting with non-specific headaches. Endoscopic sinus surgery offers a successful treatment, with no recurrences observed in a 2-year follow-up for these pediatric cases.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Rhinology
Background:
- Paranasal sinus mucoceles are uncommon in pediatric populations, frequently linked to cystic fibrosis.
- Diagnosis can be delayed due to non-specific symptoms and lack of inflammatory markers.
- Sphenoid sinus mucoceles are particularly rare in children.
Purpose of the Study:
- To report on three pediatric cases of paranasal sinus mucoceles managed surgically.
- To discuss etiology, clinical presentation, and treatment of pediatric sinus mucoceles.
- To review the existing literature on this rare condition in children.
Main Methods:
- Case series of three pediatric patients with paranasal sinus mucoceles.
- Exclusion of cystic fibrosis as an underlying condition.
- Management via endoscopic sinus surgery.
- Clinical follow-up for symptom recurrence.
Main Results:
- Three pediatric patients (2 sphenoid, 1 ethmoid) were successfully treated.
- Two sphenoid mucoceles had no identifiable cause; one presented with intractable headaches.
- One ethmoid mucocele possibly linked to recurrent sinusitis.
- All patients remained symptom-free with no recurrence after 2 years post-surgery.
Conclusions:
- Pediatric paranasal sinus mucoceles, especially sphenoid, require consideration despite rarity.
- Endoscopic sinus surgery is an effective treatment modality.
- Early diagnosis and surgical intervention are crucial for favorable outcomes.
Abstract:
Mucoceles of the paranasal sinuses are extremely rare in children and adolescents and most cases described in the literature are associated with cystic fibrosis. The condition is potentially dangerous but frequently diagnosed late or inaccurately due to its non-specific symptoms or to an absence of inflammation parameters or other clinical signs. We present 3 children with mucoceles (sphenoid sinus n = 2, ethmoid sinus n = 1) in whom cystic fibrosis was discounted and who were managed in our medical centre during the last 3 years. No aetiological factor was identified in the 2 cases of sphenoid mucocele. The main symptom in these two patients was therapy-resistant cephalgia which shifted location and varied in intensity. One child had had recurrent sinus infection which was a possible aetiological factor of the ethmoidal mucocele. All patients successfully underwent endoscopic sinus surgery. During a 2-year follow-up, all patients have remained free of symptoms and no mucocele recurrence has been observed so far. The rareness of paranasal sinus mucoceles in children, in particular its sphenoid occurrence, coupled with its relatively non-specific symptomatology prompted the authors to outline and discuss the aetiological factors, clinical findings, and therapy and to review the literature.
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