Sinus mucocele: natural history and long-term recurrence rate.
OBJECTIVE
To define the natural history, clinical signs, treatment and the modalities of medium- and long-term follow-up of patients operated for sinus mucocele.


METHODS
Retrospective study of all patients operated for sinus mucocele between January 1993 and December 2009 (n=68). Demographic data, symptoms, medical imaging findings, surgical treatment and results were recorded.


RESULTS
The mean age of patients in this series was 53 years (range: 27-82 years, sex ratio: 3/2). The most common site was fronto-ethmoidal. Fifty-one patients (75%) had a history of sinus surgery, essentially for nasal polyposis. Only 15% of mucoceles occurred spontaneously. Presenting symptoms, in decreasing order of frequency, were facial pain or headache (38%), ocular or orbital complications (28%), while 20% of patients were asymptomatic. Surgery was performed by endonasal endoscopic sinus surgery (n=57, 84%) or via a combined, transfacial and endonasal approach, associated with navigation after January 2003. The mean follow-up was 7 years (range: 4 months-16 years). During this follow-up period, 23.5% of patients developed recurrence or a second mucocele after a mean interval of 4 years.


CONCLUSIONS
This study demonstrates the high recurrence rate of mucocele, particularly in multi-operated patients with chronic sinusitis. Long-term, regular, clinical and radiological follow-up is necessary to detect asymptomatic lesions prior to the onset of complications.
Service d'ORL et de chirurgie cervico-faciale, hôpital européen Georges-Pompidou, faculté de médecine Paris-Descartes, université Paris V, 20, rue Leblanc, 75015 Paris, France.
M
M
Devars du Mayne
A
A
Moya-Plana
D
D
Malinvaud
O
O
Laccourreye
P
P
Bonfils
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D005005:Ethmoid Sinus / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005626:Frontal Sinus / Q000473:pathology / Q000601:surgery; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D033162:Incidental Findings; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009078:Mucocele / Q000175:diagnosis / Q000601:surgery*; D038361:Neuronavigation; D010254:Paranasal Sinus Diseases / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D014057:Tomography, X-Ray Computed