Endoscopic Management of Paranasal Sinus Mucoceles
Summary
Paranasal sinus mucoceles are benign, expansile cystic lesions lined by respiratory epithelium that gradually accumulate mucus and enlarge, often causing bony erosion and extension into orbital or intracranial compartments. Endoscopic management has become the gold standard, offering a minimally invasive route to achieve wide marsupialization, reestablish sinus ventilation and drainage, and reduce recurrence. Advances in high-resolution imaging facilitate preoperative assessment of bony boundaries and critical neurovascular relationships, guiding tailored endonasal approaches to frontal, ethmoid, sphenoid and maxillary mucoceles. Surgical principles focus on creating a large, permanent communication between the mucocele cavity and the nasal airway—typically via middle meatal antrostomy for maxillary lesions, frontal sinusotomy through the frontal recess, or direct transnasal sphenoidotomy—while preserving normal mucosa and minimising disruption of adjacent structures. Intraoperative navigation and angled endoscopes improve access to difficult recesses, and multidisciplinary collaboration ensures safe management of cases with orbital or skull-base involvement. Long-term follow-up confirms low rates of recurrence and restoration of sinus function, underscoring the global applicability and favourable safety profile of endoscopic techniques.
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Endoscopic Management of Paranasal Sinus Mucoceles publication trend
The graph below shows the total number of articles in endoscopic management of paranasal sinus mucoceles across all publications each year (not limited to Nature Index journals).
Technical terms
Mucocele: A mucus‐filled, epithelial‐lined cystic expansion within a paranasal sinus that may erode surrounding bone and extend into adjacent compartments.
Marsupialization: Surgical creation of a permanent opening of a cystic lesion into the nasal cavity to ensure continuous drainage and prevent re-accumulation.
Endoscopic sinus surgery: Minimally invasive intervention using nasal endoscopes and specialised instruments to access and treat sinus pathology via natural nasal corridors.
Ostium: The natural aperture connecting a paranasal sinus to the nasal cavity, critical for ventilation and drainage.
Clinoid process: A bony projection of the sphenoid bone adjacent to the optic canal, whose pneumatization can harbour mucoceles impacting the optic nerve.
References
- Endoscopic sinus surgery for maxillary sinus mucoceles. Head & Face Medicine (2006).
- The role of imaging in the management of sinonasal mucoceles. Pan African Medical Journal (2019).
- Optic compressive neuropathy secondary to anterior clinoid mucocele: diagnostic approach, a case report. Journal of Surgical Case Reports (2022).
- The Clinical Course of Paranasal Sinus Mucocoeles—A Retrospective Case Series. Journal of Clinical Medicine (2024).
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