According to the textbooks and review of Western articles. Frontal sinus had been described to be the most common site in the incidence of mucocele of the paranasal sinuses. Obliteration of the middle meatal opening or naso-antral window has been
suggested as the main mechanism of the pathogenesis of postoperative mucoceles of the maxillary sinus.
The purpose of this study is to elucidate the incidence of mucoceles in the paranasal sinus and to better understand their developmental mechanism.
@ES Materials and methods:
@EN We retrospectively analyzed 43 patients with maxillary sinus mucocele who underwent operation at Asan medical Center between 1989 and 1994, and compared with the number of frontal or ethmoidal sinus mucoceles operated during the same period
at
the
same institution. Also, we reviewed 26 articles about mucoceles of the paranasal sinuses published in the Journal of the Korean Otolaryngological Society (1960-1992).
@ES Results:
@EN There were 43 cases of maxillary sinus mucoceles ; 42 cases developed five to fifty years after Caldwell-Luc's operation and one case was primary. During the same period 6 cases of frontal or ethmoidal sinus mucoceles were operated. The
review
of
the journal of Korean Otolaryngologic Society revealed that 145 cases of maxillary sinus mucoceles, all but 3 cases developed after surgery, and 55 mucoceles of other sinus origin had been reported. On CT evaluation, middle meatal opening or
naso-antral
window, made previously, was more frequently obliterated in the mucocele side as compared to the contralateral side ; however, in several cases middle meatal opening or naso-antral window was patent in the diseased sided. Most of the mucocele
contents
were infected with single or multiple bacteria. Mucoceles of the frontal and maxillary sinus showed same histological features which consisted of epithelial lining of columnar or metaplastic squamous cells, varying glandular structures, and dense
fibrous stroma infiltrated by inflammatory cells.
@ES Conclusion :
@EN We suggest that maxillary sinus is the most frequent site of mucoceles in the paranasal sinuses at least in Korea. Obliteration of the drainage site of the sinus is considered to be most important in the pathogenesis of postoprative maxillary
sinus
mucocele; however, proliferation of the remnant mucosa surrounded by scar tissue, abnormally septated sinus, and bacterial infection might contribute to the formation and/or aggravation of the mucoceles.
|