Endoscopic Surgery for Fronto-Ethmoidal Mucoceles

Abstract

Objective To add to the existing knowledge of endoscopic surgery for fronto-ethmoidal mucoceles and to determine factors that influence the outcomes of endoscopic surgery. Study Design Case series with chart review. Setting University adult tertiary care institution. Subjects and Methods A database of patients treated surgically for mucoceles of the paranasal sinus has been kept by the senior author since 1995. It was used to identify those who have had endoscopic surgery for fronto-ethmoidal mucoceles from 1995 to 2010. All adult patients with 6 months or more of follow-up were included. The database was reviewed and assessed for variables that may affect outcome after surgery. Results Forty patients underwent 44 endoscopic procedures for treatment of fronto-ethmoidal mucoceles and the complications of surgery. The mean age was 46.3 years, and mean follow-up time was 74.9 months. Two patients had a history of head trauma. A total of 28 Draf IIa procedures, 13 Draf IIb, and 3 Draf III procedures were performed. Three patients had combined open approaches. Two patients had bilateral surgery, and 2 patients required revision surgery: 1 for restenosis after a Draf IIa procedure (1/28) and 1 for disease recurrence. Stenosis was found in a further 3 patients who had Draf IIb surgery (3/13). Conclusion The current series represents one of the largest for the endoscopic management of fronto-ethmoidal mucoceles. Endoscopic approaches are suitable for most mucoceles. The most common complication, restenosis of the frontal recess, was more likely following Draf IIb procedures (23%) than Draf IIa (3.6%) procedures.