[Statistical observations of clinical cases with frontal, ethmoid and sphenoid sinus mucoceles]

Ninety six patients with paranasal mucoceles (or pyoceles) were admitted and treated at Gunma University Hospital from 1977 to 1986 (age range 15-82 years; mean 46.4 years). We statistically investigated these cases paying a special attention to 25 patients with visual disturbance. 1) In 71 cases mucocele was located in the frontal or fronto-ethmoid sinus (FE group), in 12 it was found in the ethmoid sinus (E group), and in 13 it was situated in the sphenoid or spheno-ethmoid sinus (SE group). 2) Sixty three cases had histories of previous surgery of paranasal sinuses and 29 cases were considered to have primary mucoceles. 3) The mean age of patients with primary mucocele was 56.4, while that with postoperative mucocele was 41.2. 4) In the FE group recurrence was so frequent that some device for surgical treatment should be considered (i.e., mucous membrane grafting, prolonged insertion of silicon tubes). 5) Visual disturbance was frequently observed in both the E group (7/12) and the SE group (9/13). 6) Visual disturbance may occur when mucocele compress the optic nerve and the globe at retrobulbar portion as well as at the optic canal. Twelve cases out of 25 with visual disturbance belonged in the former type. 7) Optic atrophy was most commonly seen in the SE group, but was recognized in 1 case even in the E group and the FE group respectively. 8) In patients with sudden visual disturbance, if only they were operated within a week after the onset, their visual acuity was remarkably improved except for serious cases. 9) In the cases presented with gradually attacked or varying visual disturbance, there was no correlation between the recovery of the vision and the duration of the disturbance.