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Efficacy of endoscopic sinus surgery for paranasal sinus mucocele including modified endoscopic Lothrop procedure for frontal sinus mucocele

Published online by Cambridge University Press:  08 March 2006

Jwu Jin Khong ,
Raman Malhotra ,
Dinesh Selva  and
Peter John Wormald
Jwu Jin Khong
Affiliation:
Oculoplastic and Orbital Unit, Department of Ophthalmology, Royal Adelaide Hospital, University of Adelaide, Adelaide and Flinders Universities, Adelaide, Australia.
Raman Malhotra
Affiliation:
Oculoplastic and Orbital Unit, Department of Ophthalmology, Royal Adelaide Hospital, University of Adelaide, and the Department of Surgery-Otolaryngology, Head and Neck Surgery, Adelaide and Flinders Universities, Adelaide, Australia.
Dinesh Selva
Affiliation:
Oculoplastic and Orbital Unit, Department of Ophthalmology, Royal Adelaide Hospital, University of Adelaide, and the Department of Surgery-Otolaryngology, Head and Neck Surgery, Adelaide and Flinders Universities, Adelaide, Australia.
Peter John Wormald
Affiliation:
Oculoplastic and Orbital Unit, Department of Ophthalmology, Royal Adelaide Hospital, University of Adelaide, and the Department of Surgery-Otolaryngology, Head and Neck Surgery, Adelaide and Flinders Universities, Adelaide, Australia.
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Abstract

This study evaluated the efficacy of the modified endoscopic Lothrop procedure (MELP) for complicated frontal mucoceles and endoscopic marsupialization for other paranasal sinus mucoceles.

It was a retrospective, consecutive case review of sinus mucoceles treated endoscopically by a single surgeon over a four-year period (1998-2002).

There were 41 mucoceles in 28 patients, including 24 frontal, eight frontoethmoidal, three ethmoidal, five maxillary and one frontal mucocele. Twenty-one patients underwent the modified Lothrop procedure for frontal mucoceles, and seven underwent simple drainage and marsupialization for frontoethmoidal, ethmoidal and maxillary mucoceles. At median follow-up of 16 months, all patients had a patent mucocele opening. Patients treated by drainage and marsupialization did not have any complications or mucocele recurrence. All patients treated by the modified endoscopic Lothrop procedure had improvement in symptoms and signs. Four patients had minor complications including epistaxis and adhesions and five required further surgery. The average hospital in-patient stay was 2 ± 1.4 days.

Endoscopic techniques, including MELP are effective in the short term for the management of complex and simple paranasal sinus mucoceles. MELP has a useful place in the management of mucoceles with a significant bony partition from an adjacent sinus or nasal cavity. It is also indicated when the mucocele is associated with loss of lateral support in the sinus with risk of medial-wall collapse of the orbital contents obstructing drainage.

Keywords

MucoceleFrontal SinusEndoscopySurgical Procedures, OperativeParanasal Sinus Disease
Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 118 , Issue 5 , May 2004 , pp. 352 - 356
Copyright
© Royal Society of Medicine Press Limited 2004

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