Recurrent mucoceles

Chapter

Abstract

  • Management of recurrent mucoceles has shifted from open surgical resection toward more conservative, endoscopic marsupialization techniques. • Recurrent mucocele formation may result from incomplete marsupialization of the primary lesion or unfavorable scarring of a sinus ostium or free mucosal edge. • Mucoceles that violate the boundaries of the sinonasal cavity are at higher risk for recurrence due to the increased complexity of complete marsupialization by strictly endoscopic techniques. • Infected mucoceles (mucopyoceles) can rapidly expand and increase the incidence of local complications. • Computed tomography is absolutely required for evaluation and preoperative management, and magnetic resonance imaging is highly recommended if the primary lesion demonstrates skull-base erosion or frank intracranial extension. • The overall goal of revision mucocele surgery includes complete adjacent sinusotomy followed by wide-field marsupialization of the cyst wall to minimize the risk of scarring and entrapment of residual secretory mucosa. • Extended frontal sinus procedures, such as the Draf III (endoscopic modified Lothrop) procedure, are often necessary for recurrent frontal sinus mucoceles to increase the chances of success. • Partial (modified) endoscopic medial maxillectomy is recommended for recurrent maxillary sinus mucoceles. • Sphenoid mucoceles are addressed via a transnasal/transseptal or transethmoid approach. • Endoscopic drainage appears to be an effective technique with little morbidity in the proper hands. However, open approaches are still necessary in select cases. © 2008 Springer-Verlag.
  • Digital Object Identifier (doi)

    International Standard Book Number (isbn) 13

  • 9783540789307
  • Start Page

  • 185
  • End Page

  • 192