Case Studies in Endoscopic Sinus Surgery

A left total sphenoethmoidectomy and sinusotomy were performed, and after a minor revision for frontal sinus stenosis, follow-up visits were clear-until four years later. At this point, the patient returned with a CT report showing some ethmoid disease on the right side, along with mucosal disease in the right frontal sinus and right sphenoid. There was an expansile lesion in the supraorbital ethmoid area with erosion into the orbit.

Panelists discussed whether or not a biopsy should be done, and there was concern about the proximity of the lesion to thick bone that was located inferiorly. MRI helped show that the lesions represented two mucoceles, and despite the thick bone beneath them and their difficult location, these were successfully treated endoscopically, Dr. Kennedy reported.

The case demonstrated the value of MRI in differentiating between a tumor (inverted papilloma) and a mucocele. It also showed that even for a mucocele in a very difficult-to-access location, endoscopic surgery may be a viable option, especially when combined with computer-assisted surgical navigation, Dr. Kennedy said.

©2007 The Triological Society