Delayed development of mucocele in the fractured frontal sinus.
We present a case of delayed mucocele in the frontal sinus which occurred in 8 years after the initial trauma.A 56-year-old man visited the hospital with a complaint of his left eye protruding for years. Eight years prior, he fell down stairs and sustained an injury on the head and was diagnosed to have a fracture of the anterior wall of frontal sinus. Frontal sinus mucosa was extirpated, and the space was obliterated with bovine artificial bone.Magnetic resonance imaging and computed tomography scans demonstrated an enlargement of the left orbit, measuring 4.0 cm x 2.6 cm, occupied by a huge mucocele. Through a bicoronal approach, a rectangular window (2 x 3 cm) was made on the anterior wall of frontal sinus. The grafted bovine bone was taken out to reach the mucocele, which distended down to the orbit. The mucocele was open, and yellowish, thick, pus-like content was drained out with suction. Mucosa of the mucocele was removed as much as possible. The periorbita held in absence of most part of the orbital roof. Craniotomy site was undone after a free drainage of mucocele into the nasal cavity was ensured.The exhaustive ablation of all mucosa is a surgical principle to rid ultimate mucocele and depends on competent surgeons performing the procedure thoroughly.
Hwang
Kun
K
Department of Plastic Surgery, and Center for Advanced Medical Education by BK21 Project, Inha University College of Medicine, Incheon, Korea.
Kim
Eun Young
EY
D004322:Drainage; D005094:Exophthalmos / Q000209:etiology; D005626:Frontal Sinus / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009078:Mucocele / Q000150:complications / Q000209:etiology* / Q000601:surgery*; D009092:Mucous Membrane / Q000601:surgery; D009916:Orbital Diseases / Q000209:etiology* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012086:Reoperation; D012887:Skull Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed