Maxillary sinus mucocoeles--10 cases--8 treated endoscopically

Maxillary sinus mucocoeles are rare, but may cause significant problems outside the sinus including diplopia and cheek swelling. We present 9 patients suffering from maxillary sinus mucocoele, including one patient with bilateral involvement, representing 10 involved sinuses. Eight sinuses were treated endoscopically and followed-up for 3 to more than 6 years; one of these developed a recurrence. Two sinuses were treated using a classical external approach (Caldwell-Luc), one at the beginning of our series, and one as the endoscopic technique was difficult to perform due to loss of anatomical landmarks. One of these two sinuses developed a recurrence and was then successfully treated endoscopically. We discuss the aetiology, pathogenesis and appropriate treatment of this unusual condition. Endoscopic treatment appears to be effective and leads to minimal recurrence. The aim is to perform a wide removal of the medial wall of the maxillary sinus including most of the inferior turbinate, immediately posterior to the lachrymal duct leaving intact the sinus mucosa. In some cases, however, the endoscopic technique can be difficult to perform due to loss of essential anatomical landmarks and in these cases recourse to an external approach may be necessary.