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Sinonasal Mucocele
Philip R. Chapman, MD
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KEY FACTS

  • Imaging

    • Top Differential Diagnoses

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Expanded, chronically obstructed sinus, lined by normal respiratory epithelium and completely filled with mucus
              • From Latin "muco" = mucus + Greek "kele" = tumor or "mucous tumor"
              • Obstructed sinus and complete opacification without marginal bony expansion not considered mucocele

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Al-Qudah M: Image-guided sinus surgery in sinonasal pathologies with skull base/orbital erosion. J Craniofac Surg. 26(5):1606-8, 2015
                                          2. Lee JC et al: Computed tomography image guidance for more accurate repair of anterior table frontal sinus fractures. J Craniofac Surg. 26(1):e64-7, 2015
                                          3. Samil KS et al: Nasal Cavity and Paranasal Sinus Diseases Affecting Orbit. J Craniofac Surg. 26(4):e348-51, 2015
                                          4. Aghakhanyan G et al: Delayed post-traumatic fronto-ethmoidal sinus mucocele evaluated with short and long TE MR spectroscopy. Neuroradiol J. 26(6):693-8, 2013
                                          5. Lee JT et al: Intracranial mucocele formation in the context of longstanding chronic rhinosinusitis: A clinicopathologic series and literature review. Allergy Rhinol (Providence). 4(3):e166-75, 2013
                                          6. Scangas GA et al: The natural history and clinical characteristics of paranasal sinus mucoceles: a clinical review. Int Forum Allergy Rhinol. 3(9):712-7, 2013
                                          7. Soon SR et al: Sphenoid sinus mucocele: 10 cases and literature review. J Laryngol Otol. 124(1):44-7, 2010
                                          8. Khalil SH et al: Clinico-radiological considerations in the treatment of frontal sinus mucoceles. Rev Laryngol Otol Rhinol (Bord). 130(4-5):267-71, 2009
                                          9. Lee TJ et al: Extensive paranasal sinus mucoceles: a 15-year review of 82 cases. Am J Otolaryngol. 30(4):234-8, 2009
                                          10. Sadiq SA et al: Ophthalmic manifestations of paranasal sinus mucocoeles. Int Ophthalmol. 29(2):75-9, 2009
                                          11. Sautter NB et al: Paranasal sinus mucoceles with skull-base and/or orbital erosion: is the endoscopic approach sufficient? Otolaryngol Head Neck Surg. 139(4):570-4, 2008
                                          12. Som PM et al: Interfrontal sinus septal cell: a cause of obstructing inflammation and mucoceles. AJNR Am J Neuroradiol. 29(7):1369-71, 2008
                                          13. Fu CH et al: The difference in anatomical and invasive characteristics between primary and secondary paranasal sinus mucoceles. Otolaryngol Head Neck Surg. 136(4):621-5, 2007
                                          14. Herndon M et al: Presentation and management of extensive fronto-orbital-ethmoid mucoceles. Am J Otolaryngol. 28(3):145-7, 2007
                                          15. Andre E et al: MR spectroscopy in sinus mucocele: N-acetyl mimics of brain N-acetylaspartate. AJNR Am J Neuroradiol. 27(10):2210-3, 2006
                                          16. Eggesbø HB: Radiological imaging of inflammatory lesions in the nasal cavity and paranasal sinuses. Eur Radiol. 16(4):872-88, 2006
                                          17. Nicollas R et al: Pediatric paranasal sinus mucoceles: etiologic factors, management and outcome. Int J Pediatr Otorhinolaryngol. 70(5):905-8, 2006
                                          18. Khong JJ et al: Endoscopic sinus surgery for paranasal sinus mucocoele with orbital involvement. Eye. 18(9):877-81, 2004
                                          19. Kosling S et al: Mucoceles of the sphenoid sinus. Eur J Radiol. 51(1):1-5, 2004
                                          20. Landsberg R et al: Magnetic resonance imaging--aided navigation in endoscopic sinus surgery of a bone-destructive sphenoclinoid mucocele. Ann Otol Rhinol Laryngol. 112(8):740-4, 2003
                                          21. Har-El G: Endoscopic management of 108 sinus mucoceles. Laryngoscope. 111(12): 2131-4, 2001
                                          22. Lloyd G et al: Optimum imaging for mucoceles. J Laryngol Otol. 114(3): 233-6, 2000
                                          23. Nakasato T et al: Virtual CT endoscopy in determining safe surgical entrance points for paranasal mucoceles. J Comput Assist Tomogr. 24(3): 486-92, 2000
                                          24. Rombaux P et al: Endoscopic endonasal surgery for paranasal sinus mucoceles. Acta Otorhinolaryngol Belg. 54(2): 115-22, 2000
                                          25. Busaba NY et al: Maxillary sinus mucoceles: clinical presentation and long-term results of endoscopic surgical treatment. Laryngoscope. 109(9): 1446-9, 1999
                                          26. Weissman JL et al: Double mucocele of the paranasal sinuses. AJNR Am J Neuroradiol. 15(7): 1263-4, 1994
                                          27. Van Tassel P et al: Mucoceles of the paranasal sinuses: MR imaging with CT correlation. AJR Am J Roentgenol. 153(2):407-12, 1989
                                          28. Hesselink JR et al: Evaluation of mucoceles of the paranasal sinuses with computed tomography. Radiology. 133(2):397-400, 1979
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Pathology

                                                • Clinical Issues

                                                  TERMINOLOGY

                                                  • Definitions

                                                    • Expanded, chronically obstructed sinus, lined by normal respiratory epithelium and completely filled with mucus
                                                      • From Latin "muco" = mucus + Greek "kele" = tumor or "mucous tumor"
                                                      • Obstructed sinus and complete opacification without marginal bony expansion not considered mucocele

                                                  IMAGING

                                                  • General Features

                                                    • Radiographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Staging, Grading, & Classification

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Al-Qudah M: Image-guided sinus surgery in sinonasal pathologies with skull base/orbital erosion. J Craniofac Surg. 26(5):1606-8, 2015
                                                                                  2. Lee JC et al: Computed tomography image guidance for more accurate repair of anterior table frontal sinus fractures. J Craniofac Surg. 26(1):e64-7, 2015
                                                                                  3. Samil KS et al: Nasal Cavity and Paranasal Sinus Diseases Affecting Orbit. J Craniofac Surg. 26(4):e348-51, 2015
                                                                                  4. Aghakhanyan G et al: Delayed post-traumatic fronto-ethmoidal sinus mucocele evaluated with short and long TE MR spectroscopy. Neuroradiol J. 26(6):693-8, 2013
                                                                                  5. Lee JT et al: Intracranial mucocele formation in the context of longstanding chronic rhinosinusitis: A clinicopathologic series and literature review. Allergy Rhinol (Providence). 4(3):e166-75, 2013
                                                                                  6. Scangas GA et al: The natural history and clinical characteristics of paranasal sinus mucoceles: a clinical review. Int Forum Allergy Rhinol. 3(9):712-7, 2013
                                                                                  7. Soon SR et al: Sphenoid sinus mucocele: 10 cases and literature review. J Laryngol Otol. 124(1):44-7, 2010
                                                                                  8. Khalil SH et al: Clinico-radiological considerations in the treatment of frontal sinus mucoceles. Rev Laryngol Otol Rhinol (Bord). 130(4-5):267-71, 2009
                                                                                  9. Lee TJ et al: Extensive paranasal sinus mucoceles: a 15-year review of 82 cases. Am J Otolaryngol. 30(4):234-8, 2009
                                                                                  10. Sadiq SA et al: Ophthalmic manifestations of paranasal sinus mucocoeles. Int Ophthalmol. 29(2):75-9, 2009
                                                                                  11. Sautter NB et al: Paranasal sinus mucoceles with skull-base and/or orbital erosion: is the endoscopic approach sufficient? Otolaryngol Head Neck Surg. 139(4):570-4, 2008
                                                                                  12. Som PM et al: Interfrontal sinus septal cell: a cause of obstructing inflammation and mucoceles. AJNR Am J Neuroradiol. 29(7):1369-71, 2008
                                                                                  13. Fu CH et al: The difference in anatomical and invasive characteristics between primary and secondary paranasal sinus mucoceles. Otolaryngol Head Neck Surg. 136(4):621-5, 2007
                                                                                  14. Herndon M et al: Presentation and management of extensive fronto-orbital-ethmoid mucoceles. Am J Otolaryngol. 28(3):145-7, 2007
                                                                                  15. Andre E et al: MR spectroscopy in sinus mucocele: N-acetyl mimics of brain N-acetylaspartate. AJNR Am J Neuroradiol. 27(10):2210-3, 2006
                                                                                  16. Eggesbø HB: Radiological imaging of inflammatory lesions in the nasal cavity and paranasal sinuses. Eur Radiol. 16(4):872-88, 2006
                                                                                  17. Nicollas R et al: Pediatric paranasal sinus mucoceles: etiologic factors, management and outcome. Int J Pediatr Otorhinolaryngol. 70(5):905-8, 2006
                                                                                  18. Khong JJ et al: Endoscopic sinus surgery for paranasal sinus mucocoele with orbital involvement. Eye. 18(9):877-81, 2004
                                                                                  19. Kosling S et al: Mucoceles of the sphenoid sinus. Eur J Radiol. 51(1):1-5, 2004
                                                                                  20. Landsberg R et al: Magnetic resonance imaging--aided navigation in endoscopic sinus surgery of a bone-destructive sphenoclinoid mucocele. Ann Otol Rhinol Laryngol. 112(8):740-4, 2003
                                                                                  21. Har-El G: Endoscopic management of 108 sinus mucoceles. Laryngoscope. 111(12): 2131-4, 2001
                                                                                  22. Lloyd G et al: Optimum imaging for mucoceles. J Laryngol Otol. 114(3): 233-6, 2000
                                                                                  23. Nakasato T et al: Virtual CT endoscopy in determining safe surgical entrance points for paranasal mucoceles. J Comput Assist Tomogr. 24(3): 486-92, 2000
                                                                                  24. Rombaux P et al: Endoscopic endonasal surgery for paranasal sinus mucoceles. Acta Otorhinolaryngol Belg. 54(2): 115-22, 2000
                                                                                  25. Busaba NY et al: Maxillary sinus mucoceles: clinical presentation and long-term results of endoscopic surgical treatment. Laryngoscope. 109(9): 1446-9, 1999
                                                                                  26. Weissman JL et al: Double mucocele of the paranasal sinuses. AJNR Am J Neuroradiol. 15(7): 1263-4, 1994
                                                                                  27. Van Tassel P et al: Mucoceles of the paranasal sinuses: MR imaging with CT correlation. AJR Am J Roentgenol. 153(2):407-12, 1989
                                                                                  28. Hesselink JR et al: Evaluation of mucoceles of the paranasal sinuses with computed tomography. Radiology. 133(2):397-400, 1979