Clinico-radiological considerations in the treatment of frontal sinus mucoceles.
OBJECTIVE
To review our experience in the management of frontal sinus mucoceles with emphasis on the presentation and role of preoperative imaging in the choice of the surgical approach.


METHODS
A retrospective audit of patients with frontal sinus mucoceles who were treated by the first author (HSK) was carried out. All patients had a diagnosis of frontal sinus mucoceles confirmed on clinical findings, CT and Magnetic Resonance Imaging. The operative findings were also recorded.


RESULTS
Fourteen patients with frontal sinus mucoceles were treated between January 2005 and June 2009. The mean age of the patients was 52.6 years (range 21-88 years). There were 9 males (64.3%) and 5 females (35.7%). The presenting symptoms of the patients in this series were periorbital swelling (35.7%), headache (35.7%), frontal swelling (21.4%) and proptosis (14.3%). The anterior table of the frontal sinus was eroded in 64.3% of patients and the posterior table in 50%. A complete intrasinus septum was found in only 14.3% of patients. One patient (7.1%) had a Type IV Kuhn cell. The operative findings were in keeping with the radiological features.


CONCLUSIONS
The radiological features of the mucocele were crucial in the decision-making process for the choice of the surgical technique. The state of anterior and posterior table of frontal sinus, type of Kuhn cell and presence of a complete intrasinus septum all influence the choice of surgical approach.
Khalil
S H
SH
Derriford Hospital, Department of Otolaryngology, United Kingdom. Hisham.Khalil@phnt.swest.nhs.uk
Adams
M W
MW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003952:Diagnostic Imaging; D005260:Female; D005626:Frontal Sinus / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009078:Mucocele / Q000473:pathology* / Q000601:surgery; D010254:Paranasal Sinus Diseases / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies