Compartmentalized maxillary sinus mucocele

Postoperative maxillary cysts: magnetic resonance imaging compared with computerized tomography

OBJECTIVES

The aim was to investigate magnetic resonance (MR) and computerized tomography (CT) images and compare MR and CT image features of postoperative maxillary cysts (POMC).

STUDY DESIGN

We retrospectively evaluated MR and CT images of 7 POMC patients. Number of the cysts, border, bone expansion, CT value, signal intensity, and contrast enhancement were observed.

RESULTS

On CT images, 15 cysts were detected. Fourteen cysts showed smooth border. Bone expansion was found in 10 cysts. Mean CT value of each cyst ranged from 23 to 50 Hounsfield units. On MR images, 18 cysts were detected. Twelve cysts showed smooth border. Bone expansion was not observed. Most cysts showed intermediate signal intensity on T1-weighted images, and high or nonhomogeneous intermediate/high signal intensity on T2-weighted images with the fat suppression technique. No cyst showed contrast enhancement in both examinations.

CONCLUSION

The CT images revealed bony information, and the MR images clearly demonstrated border of POMC. POMC should be evaluated with both CT and MR imaging.

Endoscopic sinus surgery for maxillary sinus mucoceles

BACKGROUND

Maxillary sinus mucoceles are relatively rare among all paranasal sinus mucoceles. With the introduction of endoscopic sinus surgical techniques, rhinologic surgeons prefer transnasal endoscopic management of sinus mucoceles. The aim of this study is to describe the clinical presentation of maxillary sinus mucoceles and to establish the efficacy of endoscopic management of sinus mucoceles.

METHODS

Between 2003 and 2005, 14 patients underwent endoscopic sinus surgery for maxillary sinus mucocele. The presenting sign and symptoms, radiological findings, surgical management and need for revision surgery were reviewed.

RESULTS

There were eight males and six females with an age range of 14 to 65. Ten patients complained of nasal obstruction, five of nasal drainage, five of cheek pressure or pain and one of proptosis of the eye and cheek swelling. The maxillary sinus and ipsilateral ethmoid sinus involvement on computed tomographic studies was seen in 4 patients. Four patients had history of endoscopic ethmoidectomy surgery for ethmoid sinusitis and one had Caldwell-Luc operation in the past. Ethmoidectomy with middle meatal antrostomy and marsupialization of the mucocele was performed in all patients. Postoperative follow-up ranged between 8 to 48 months. All patients had a patent middle meatal antrostomy and healthy maxillary sinus mucosa. No patients need revision surgery.

CONCLUSION

The most common causes of mucoceles are chronic infection, allergic sinonasal disease, trauma and previous surgery. In 64% of the patients of our study cause remains uncertain. Endoscopic sinus surgery is an effective treatment for maxillary sinus mucoceles with a favorable long-term outcome.

Lesions of the maxilla

The maxilla may be involved by a wide range of pathologic conditions. Lesions originating in the maxilla may involve the adjacent orbit, oral cavity, or retroantral spaces. Recognition of this relationship plays an important role in diagnosis, prognosis, and presurgical planning.