Endoscopic Treatment of Huge Sinus Mucoceles Causing Orbital Symptoms

Paranasal sinus mucoceles are accumulation of mucoid secretions and desquamated epithelium within the sinus causing distension of its wall. They occur mostly in the frontal and ethmoid sinuses. Patients with giant frontal or ethmoidal sinus mucoceles suffer from orbital symptoms such as proptosis, visual disturbance, periorbital swelling, pain, or visual disturbance mostly, but they can also have rhinologic or neurologic symptoms. The purpose of this study is to evaluate the efficacy of endoscopic marsupialization for treating giant frontal and ethmoidal sinus mucoceles causing orbital symptoms.

This study was a retrospective, consecutive clinical review of patients with giant frontal and ethmoidal sinus mucoceles with orbital symptoms, who were treated by endoscopic marsupialization between January 2012 and August 2019. Medical records including age, gender, nasal and orbital symptoms, imaging findings, and surgical methods were reviewed.

There were 15 patients with giant frontal and/or ethmoidal sinus mucoceles accompanied with orbital symptoms. The mean age of the patients was 50.5 years. One patient had previously undergone endoscopic sinus surgery for chronic rhinosinusitis. Within 15 patients, the main orbital symptoms were visual disturbance (6 patients), proptosis (8 patients), eyelid swelling (6 patients), and periorbital pain (1 patient). Other symptoms included nasal congestion, rhinorrhea, and headache. All patients underwent endoscopic marsupialization of the mucocele and had improvement in nasal and orbital signs and symptoms.

Endoscopic marsupialization is an effective treatment for giant frontal and ethmoidal mucoceles with orbital symptoms.