ABSTRACT
INTRODUCTION: A nasosinus mucocele is a pseudocystic process filled with mucus arising within the sinus. Despite its benign histology, potential ophthalimic risks are related to mass effect and expansion to the orbit by bone destruction with compression of optic nerves. PURPOSE: We describe mechanisms of ophthalimic involvement in patients with paranasal sinus mucoceles, radiological appearance, treatment and prognosis of this disease. MATERIALS AND METHODS: We report 5 cases of paranasal sinus mucocele with ophthalmic complications seen between January 2007 and December 2011 on the ENT and MFS service of La Rabta University hospital. RESULTS: The reason for consultation was: unilateral proptosis in 4 patients, diplopia in 2 patients and medial canthal swelling in 3 patients. Facial computed tomography showed a mucocele in the frontal sinus in two patients, in the ethmoid-frontal sinuses in two patients and in the ethmoid-maxillary sinuses in one patient. We found erosion of the orbital walls and displacement of the globe in all cases, extra-axial proptosis in one case, compression of the extraocular muscles in 4 cases and stretching of the optic nerve in three cases. All patients were treated initially with antibiotics then surgery. The postoperative course was uneventful with no recurrence. CONCLUSION: It is necessary to diagnose mucoceles as early as possible and plan surgical excision before growth of the mass irreversibly compromises visual function.
Subject(s)
Eye Diseases/etiology , Mucocele/complications , Paranasal Sinus Diseases/complications , Adult , Aged , Diplopia/diagnosis , Diplopia/epidemiology , Diplopia/etiology , Diplopia/surgery , Exophthalmos/diagnosis , Exophthalmos/epidemiology , Exophthalmos/etiology , Exophthalmos/surgery , Eye Diseases/diagnostic imaging , Eye Diseases/epidemiology , Eye Diseases/surgery , Female , Humans , Male , Middle Aged , Mucocele/diagnostic imaging , Mucocele/epidemiology , Mucocele/surgery , Ophthalmologic Surgical Procedures , Paranasal Sinus Diseases/diagnostic imaging , Paranasal Sinus Diseases/epidemiology , Paranasal Sinus Diseases/surgery , Retrospective Studies , Tomography, X-Ray ComputedSubject(s)
Mucormycosis/diagnosis , Orbital Diseases/microbiology , Rhinitis/microbiology , Sinusitis/microbiology , Tomography, X-Ray Computed , Adult , Antifungal Agents/therapeutic use , Combined Modality Therapy , Debridement , Delayed Diagnosis , Diabetes Mellitus, Type 1/complications , Diabetic Coma/etiology , Edema/etiology , Facial Dermatoses/etiology , Fatal Outcome , Female , Humans , Mucormycosis/diagnostic imaging , Mucormycosis/drug therapy , Mucormycosis/surgery , Orbital Diseases/diagnostic imaging , Orbital Diseases/drug therapy , Orbital Diseases/surgery , Rhinitis/diagnostic imaging , Rhinitis/drug therapy , Rhinitis/surgery , Sinusitis/diagnostic imaging , Sinusitis/drug therapy , Sinusitis/surgeryABSTRACT
Introduction : La rhinorrhee cerebrospinale (rCS) resulte d'une breche osteomeningee faisant communiquer les cavites naso-sinusiennes avec les espaces sous-arachnoidiens. Sa gravite est liee au risque de complications infectieuses endocraniennes. Objectifs : discuter les modalites de prise en charge de la rCS et en analyser les facteurs d'echec. Patients et methode : Il s'agit d'une etude retrospective a propos de 15 patients presentant une rhinorrhee cerebrospinale en rapport avec une breche meningee traitee dans notre service. Resultats : L'age moyen de nos patients etait de 44;9 ans. Le motif de consultation etait une rhinorrhee claire intermittente. la notion de meningite etait rapportee dans 2cas. Un scanner du massif facial etait pratique dans tous les cas. Une cisterno IRM etait pratiquee dans 7 cas. La voie endoscopique etait adoptee dans14 cas et la voie combinee dans 1 cas. L'interposition de la greffe etait faite selon la procedure overlay dans tous les cas. Deux recidives ont ete notees et ont ete reprises chirurgicalement avec succes. Conclusion : La voie endonasale est une approche efficace et non invasive des breches osteomeningees. elle trouve son indication meme en cas d'echec de la voie transcranienne
Subject(s)
Cerebrospinal Fluid Rhinorrhea/complications , Cerebrospinal Fluid Rhinorrhea/surgery , Cerebrospinal Fluid Rhinorrhea/therapy , Treatment FailureABSTRACT
INTRODUCTION: Granulomatous invasive aspergillosis rhinosinusitis is a rare disease. Anatomopathologic and mycological examination allows the diagnosis. Treatment must be rapidly started in order to avoid orbital and intracranial complications. OBJECTIVES: To analyze the main clinical, radiological, histopathological, mycological and therapeutic aspects of granulomatous invasive aspergillosis rhinosinusitis. PATIENTS AND METHODS: This is a retrospective study included five patients operated for granulomatous invasive aspergillosis rhinosinusitis at the Otorhinolaryngology Head and Neck Department of La Rabta Hospital from 2000 to 2011. RESULTS: These are four women and one man with mean age of 24.8 years. Functional symptoms were dominated by nasal obstruction and purulent rhinorrhea. Imaging showed a unilateral pansinusien filling extended to the nasal cavity with bone lysis. An orbital and endocranial extension was noted in two cases. Endonasal approach was performed in four patients and external approach in one patient. Anatomopathologic and mycological examination confirmed the diagnosis. All patients were started on antifungal therapy. One reccurence had been noted. Endonasal approach was performed. CONCLUSION: Granulomatous invasive aspergillosis rhinosinusitis is a rare infection. The prognosis is particularly serious which warrants a rapid therapeutic care to avoid complications.