Our personal cohort

comprises 266 cases which is largely the result of referrals from the United Kingdom's postgraduate
ophthalmic hospital, Moorfields, with which we have had a longstanding relationship. Other large
series are shown in
Objectives: We present the clinical and radiological features, treatment protocols, and medium-long-
term results of our patients following surgery for paranasal sinus mucocele, along with a review of
the relevant literature. Materials and methods: A total of 18 patients (11 women and 7 men) who
underwent surgery for paranasal sinus mucocele at Kocaeli University Faculty of Medicine,
Department of Otolaryngology, between 2006 and 2013 were examined retrospectively. The mean
patient age was 41 (range 4-73). Demographic and radiological features, symptoms, treatment
protocols, and postoperative outcomes were recorded. Results: The most frequently affected sinus
was the maxillary sinus (n=9, 50%) followed by the frontal sinus (n=6, 33%) and sphenoidal sinus
(n=3, 16%). The main symptom was headache. Endoscopic marsupialization of the mucocele was
applied in all 18 patients, while frontal sinus exploration with the osteoplastic flap procedure was
performed in one patient and the Caldwell-Luc operation was performed in another patient. The
Caldwell-Luc procedure was subsequently required in one patient (6%) and endoscopic revision
surgery was required in another patient (6%). Conclusion: Sinus mucocele that enlarges, eroding the
surrounding bone tissue, and induces various clinical symptoms due to the impression of the
expansile mass, is treated surgically, and must be planned carefully to prevent serious complications.

Mucocoeles of the paranasal sinuses often enlarge slowly resulting in local bone erosion with
subsequent extension into the adjacent orbit or intracranial space. We have reviewed the
management of 59 patients with 68 mucocoeles. The variety of presentations is examined and
discussed. Although diplopia has previously been stated as a very common finding we have found
this not to be the case and believe that it may be that previous reports originate from ophthalmology
centres. Forty-four patients underwent endoscopic surgical management of their mucocoeles, nine
had a combined external and endoscopic procedure and 14 patients had an external approach. One
patient needed no surgery. The mean follow-up period was 6 years 3 months. There was the lowest
number of recurrences in the endoscopic surgical group. We emphasize the importance of long-term
follow-up.NOTHINGham uk

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

Patients and method

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 endoscopicsinus 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.

Conclusion
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.

This retrospective study was based on a review of the medical charts of all patients operated for
sinus mucocele between January 1993 and December 2009: 68 patients with a mean age of 53 years
(range: 27 to 82 years) with a sex ratio of 3/2. The number of mucoceles operated has increased
since January 2000: 18 cases were reported before 2000, 50 cases were reported after January 2000.
The patient’s history, presenting symptoms, clinical and radiological signs and treatment were
analysed. Fifty-one (75%) of these 68 pa

M. Devars du Mayne , A. Moya-Plana , D. Malinvaud , O. Laccourreye , P. Bonfils

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