Sinus mucocele: natural history and long-term recurrence rate

Eur Ann Otorhinolaryngol Head Neck Dis. 2012 Jun;129(3):125-30. doi: 10.1016/j.anorl.2011.10.002. Epub 2012 Jan 5.


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.

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 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.

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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Endoscopy
  • Ethmoid Sinus / pathology
  • Ethmoid Sinus / surgery
  • Female
  • Follow-Up Studies
  • Frontal Sinus / pathology
  • Frontal Sinus / surgery
  • Humans
  • Image Interpretation, Computer-Assisted
  • Incidental Findings
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Mucocele / diagnosis
  • Mucocele / surgery*
  • Neuronavigation
  • Paranasal Sinus Diseases / diagnosis
  • Paranasal Sinus Diseases / surgery*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / surgery*
  • Recurrence
  • Reoperation
  • Tomography, X-Ray Computed