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

Hakim Benkhatar1, Idir Khettab, Philippe Sultanik

  • 1ORL, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France. hakim.benkhatar@egp.aphp.fr.

Ear, Nose, & Throat Journal
|October 2, 2018
PubMed

Insights

Long-term follow-up after functional endoscopic sinus surgery for nasal polyposis reveals a significant risk of mucocele development, particularly with high preoperative Lund-Mackay scores. Endoscopic marsupialization is effective, though frontal mucoceles may recur.

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.

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