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Published on: January 17, 2018
Endoscopic management of frontal sinus mucoeceles with anterior table erosion
Bradford A Woodworth1, Richard J Harvey, Jeffrey G Neal
1Department of Otorhinolaryngology--Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Objective:
To describe the endoscopic management of frontal sinus mucoeceles with anterior table erosion. Previous hardware exposure and subsequent contour defects were also assessed.
Design:
Retrospective case series.
Methods:
Thirty-seven patients (mean 48 yrs, range 20-78) with frontal sinus mucoeceles and anterior table erosion, endoscopically managed in a tertiary care setting, were reviewed. The demographic data, defect size, surgical technique, presence of exposed hardware, outcomes, and clinical follow-up were collected for outcome assessment
Results:
The average follow-up was 32.6 months (range, 6-73). The overall long-term success rate with our initial endoscopic approach was 92% (34/37). The average size of anterior table defects was 181 mm2 (4-1155). Twelve patients had prior osteoplastic flaps (OPF) with obliteration and 57% (21/37) had previous endoscopic sinus surgeries. Ten patients with prior OPF operations had hardware exposed within the sinus from previous surgeries. Two patients eventually required an OPF with fat obliteration. Most defects were either unnoticeable or cosmetically acceptable to the patients. Only one patient required a contouring plate six months after the procedure. Ninety percent of patients were successfully managed with exposed hardware left in situ.
Conclusions:
Endoscopic marsupialization of frontal sinus mucoeceles with anterior table erosion has a high success rate with a good cosmetic outcome, often without routine reconstruction. Revision cases and those with exposed hardware did not prevent successful management.
