Mucocele development after endoscopic sinus surgery for nasal polyposis: A long-term analysis

Area of Science:

• Otolaryngology
• Surgical Complications
• Rhinology

Background:

• Nasal polyposis often requires functional endoscopic sinus surgery (FESS).
• Mucocele development is a potential long-term complication following FESS.
• Understanding risk factors and effective management is crucial for patient outcomes.

Purpose of the Study:

• To determine the prevalence of long-term mucocele development after FESS for nasal polyposis.
• To identify preoperative variables associated with mucocele formation.
• To analyze the management strategies for postoperative mucoceles.

Main Methods:

• Retrospective analysis of 153 patients undergoing FESS for nasal polyposis with at least 7 years of follow-up.
• Clinical and radiological evaluations for mucocele diagnosis.
• Univariate and multivariate statistical analyses to identify risk factors.

Main Results:

• The postoperative mucocele rate was 13.1% (20 patients), with a mean diagnosis delay of 6.25 years.
• A high preoperative Lund-Mackay score (>19) was identified as a significant risk factor (p = 0.04).
• Endoscopic marsupialization was successful in 19 patients; one frontal mucocele recurred, and one patient needed external approaches.

Conclusions:

• Mucocele risk after FESS for nasal polyposis is considerable, especially with high preoperative Lund-Mackay scores.
• Long-term clinical follow-up is recommended, with imaging guided by symptoms.
• Endoscopic marsupialization is effective, but frontal mucoceles exhibit a higher recurrence rate.