Bilateral Rhino-Orbital-Cerebral Mucormycosis.

This case report discusses a diagnosis of rhino-orbital-cerebral mucormycosis in a man aged 61 years who presented with vision loss, ophthalmoplegia, and ptosis.

Nasal endoscopy: What have we been missing?

Despite the widespread adoption of nasal endoscopy (NE) in the evaluation of sinonasal disease, its diagnostic potential may still be underutilized. Developments in endoscopic technology have led to significant improvements in video quality and maneuverability. However, there is concern that NE continues to be used primarily for the identification of gross pathology, with relative neglect of more subtle findings such as surface features of inflammation and mucus. With fewer technical limitations to perceive these abnormalities, there is potential to greatly improve the diagnostic value of NE. The reader is herein asked to consider several important visual nuances encountered during NE, with the hope that this engenders an appreciation of the versatility of NE as a diagnostic tool.

Computer-Aided Diagnosis of Maxillary Sinus Anomalies: Validation and Clinical Correlation.

OBJECTIVE: Computer aided diagnostics (CAD) systems can automate the differentiation of maxillary sinus (MS) with and without opacification, simplifying the typically laborious process and aiding in clinical insight discovery within large cohorts. METHODS: This study uses Hamburg City Health Study (HCHS) a large, prospective, long-term, population-based cohort study of participants between 45 and 74 years of age. We develop a CAD system using an ensemble of 3D Convolutional Neural Network (CNN) to analyze cranial MRIs, distinguishing MS with opacifications (polyps, cysts, mucosal thickening) from MS without opacifications. The system is used to find correlations of participants with and without MS opacifications with clinical data (smoking, alcohol, BMI, asthma, bronchitis, sex, age, leukocyte count, C-reactive protein, allergies). RESULTS: The evaluation metrics of CAD system (Area Under Receiver Operator Characteristic: 0.95, sensitivity: 0.85, specificity: 0.90) demonstrated the effectiveness of our approach. MS with opacification group exhibited higher alcohol consumption, higher BMI, higher incidence of intrinsic asthma and extrinsic asthma. Male sex had higher prevalence of MS opacifications. Participants with MS opacifications had higher incidence of hay fever and house dust allergy but lower incidence of bee/wasp venom allergy. CONCLUSION: The study demonstrates a 3D CNN's ability to distinguish MS with and without opacifications, improving automated diagnosis and aiding in correlating clinical data in population studies. LEVEL OF EVIDENCE: 3 Laryngoscope, 134:3927-3934, 2024.

A novel staging system to consolidate silent sinus syndrome and chronic maxillary atelectasis: A systematic review and case series.

KEY POINTS: Silent sinus syndrome (SSS) and chronic maxillary atelectasis (CMA) represent an overlapping clinical entity, both likely lying on the spectrum of one disease process. There is widespread inconsistency of diagnosis in the literature of reported cases of SSS and CMA. We propose a novel, comprehensive staging system to simplify diagnosis and inform management.

Silent sinus syndrome in children / Síndrome del Seno Silente en Niños

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Paciente com proptose ocular associado a mucocele etmoidal: apresentação clínica e tratamento / Patient with ocular properties associated with ethmoidal mucocele: clinical presentation and treatment

Resumo Relato de um caso clínico de proptose ocular relacionado com mucocele etmoidal, o caso é raro e seu acometimento ocular não é comumente relacionado na literatura. Ressaltamos ainda sua apresentação clínica e o tratamento instituído. W.L.S, Paciente do sexo masculino, 27 anos procedente de Fortaleza-CE. Comparece ao ambulatório HUWC com queixa de baixa da acuidade visual percebida há 10 dias em olho direito (OD). Ao exame oftalmológico melhor acuidade visual corrigida de 20/200 OD e 20/20 olho esquerdo (OE), ausência de abdução e elevação do OD com ptose leve (distância margem reflexo 1-2 mm) e diplopia ao olhar para direita. Proptose OD de aspecto axial de grau moderado (24mm). Biomicroscopia lâmpada de fenda sem alterações. Pressão intraocular: 18mmHg OD 12 mmHg OE. Fundo de olho: OD aspecto palidez discreta de disco, sem outras alterações e OE dentro da normalidade. Solicitada tomografia de crânio (TC) que demonstrou presença de lesão arredondada em área do seio etmoidal penetrando parede óssea da órbita do OD sugestiva de mucocele etmoidal. Encaminhado para serviço de otorrinolaringologia do HUWC, sendo submetido a procedimento cirúrgico endoscópico etmoidectomia. Um mês após o procedimento cirúrgico a acuidade visual OD 20/25, movimentos oculares presentes e simétricos, ausência de diplopia e persistência de leve palidez em OD. Expansão da mucocele pode ocorrer ao longo de muitos anos ou rapidamente. Acometimento ocular com baixa da acuidade visual é incomum como primeiro sintoma, quando ocorre merece tratamento imediato. O tratamento cirúrgico é geralmente indicado no caso e deve ser instituído assim que possível para adequada recuperação visual.

Abstract Report of a clinical case of ocular proptosis related to ethmoidal mucocele, the case is rare and ocular involvement is not commonly related in the literature. We also emphasize its clinical presentation and the treatment instituted. W.L.S., male, 27 years old from Fortaleza-CE. He presents to the HUWC outpatient clinic complaining of low visual acuity perceived for 10 days in the right eye (OD). The ophthalmologic exam showed a best corrected visual acuity of 20/200 OD and 20/20 left eye (OS), absence of abduction and elevation of OD with light ptosis (distance margin 1 - 2 mm) and diplopia when looking to the right. Proptose OD of moderate aspect axial aspect (24mm). Biomicroscopy slit lamp without changes. Intraocular pressure: 18mmHg OD 12 mmHg OS. Background of eye: OD discrete pallor disk appearance, no other changes and OS within normality. A CT scan was performed that showed presence of a rounded lesion in the ethmoidal sinus area penetrating the bone wall of the OD orbit suggestive of ethmoidal mucocele. Forwarded to the otorhinolaryngology service of the HUWC, being submitted to endoscopic surgical procedure etmoidectomy. One month after the surgical procedure visual acuity of OD 20/25, present and symmetrical ocular movements, absence of diplopia and persistence of mild pallor in OD. Expansion of mucocele may occur over many years or rapidly. Ocular involvement with low visual acuity is uncommon as the first symptom, when it occurs it deserves immediate treatment. Surgical treatment is generally indicated in the case and should be instituted as soon as possible for adequate visual recovery.

Sinusits fúngica paranasal no invasiva: Reporte de caso / Non Invasive Fungal Paranasal Sinusits. Case Report

La bola fúngica del seno maxilar es una sinusitis fúngica no invasiva. El aumento de pacientes con alguna forma de inmunocompromiso se ha asociado con el aumento en la prevalencia de la enfermedad. Presentamos el caso de un paciente diabético, que consultó durante un año al sistema de salud antes de realizarle el diagnóstico de bola fúngica por Aspergillus en el seno maxilar.

Fungal balls are non invasive sinusits of paranasal sinuses. Rises in the number of immune compromised patents has lead to an increase in prevalence of the disease. We report a case of a diabetc patent, who sought advice for one year before the diagnosis of an Aspergillus fungal ball of the maxillary sinus was made.

Patología unilateral de senos paranasales con compromiso predominante de un seno: Descripción de serie de casos / Unilateral paranasal sinus disease with predominant commitment of one sinus: Case series description

Introducción: El velamiento de una cavidad paranasal representa un desafío diagnóstico y puede ser causado por diversas patologías. El examen clínico generalmente es insuficiente para orientar la conducta siendo necesario un estudio completo que incluya endoscopía, imágenes e histología para lograr un diagnóstico definitivo. Objetivo: Describir la impresión clínica, imagenológica, quirúrgica e histológica de pacientes con patología unilateral de senos paranasales. Material y método: Serie retrospectiva de 32 pacientes con patología sinusal unilateral operados en Hospital Clínico de la Universidad de Chile entre 2012 y 2014. Se consideró como criterio de inclusión el compromiso predominante de un seno paranasal en el estudio imagenológico. Se describen las variables: síntoma principal, impresión diagnóstica; clínica, imagenológica, quirúrgica, seno comprometido, entre otras. Resultados: El síntoma principal más frecuente fue obstrucción nasal (56%). Los diagnósticos más frecuentes fueron: patología inflamatoria (84%): pólipo antrocoanal (31%), mucocele (22%) y bola fúngica (22%) y patología tumoral benigna: papiloma invertido (16%), siendo el seno maxilar el más afectado (90%). La impresión diagnóstica quirúrgica fue más precisa que la imagenológica en determinar el diagnóstico definitivo, aunque esta diferencia no alcanzó significancia estadística. Discusión: Patología compleja que requiere estudio completo incluyendo endoscopía. Las imágenes son el segundo pilar en el diagnóstico y deben solicitarse de acuerdo a los hallazgos. El diagnóstico quirúrgico provee una mayor precisión diagnóstica. Conclusiones: Se incluyen varias patologías bajo este concepto, la patología inflamatoria predomina pero se debe tener alto índice de sospecha dado la relativa frecuencia de patología tumoral.

Introduction: Paranasal sinus opacity represents a diagnostic challenge and can be caused by diverse pathologies. Clinical examination is generally insufficient to achieve a definitive diagnosis and it is necessary a complete study including endoscopy, imaging and histology. Aim: To describe clinical, radiographical, surgical and histological diagnostic impressions of patients with unilateral sinus disease. Material and method: 32 retrospective serie with unilateral sinus disease treated at Hospital Clínico de la Universidad de Chile, between 2012 and 2014. The predominant commitment of one sinus on the tomography was considered as inclusion criterion. Principal symtom, clinical, radiographical and surgical diagnostic impressions, committed sinus, among others variables were studied. Results: The most frequent symtom was nasal obstruction (56%). The most frequent diagnoses were: inflammatory disease (84%): antrochoanal polyp (31%), mucocele (22%) and fungus ball (22%) and benign tumor: inverted papilloma (16%). The maxillary sinus was affected in 90%. Surgical diagnostic impression was more precise than radiographical impression in determining the definitive diagnosis, although this difference did not reach statistics significance. Discussion: Unilateral sinus disease is a complex pathology that requires comprehensive study including endoscopy. Images are the second pillar in the diagnosis and should be requested according to the findings. Surgical diagnostic impression provides greater diagnostic presicion. Conclusions: Several pathologies are included under this concept, inflammatory disease prevails but it is necessary to have high index of suspicion in view of the relative frequency of tumour pathology.

Sospecha clínica y tratamiento quirúrgico de los mucoceles esfenoidales / Diagnosis and surgical treatment of sphenoid mucoceles

Introducción: Los mucoceles son formaciones benignas de lento crecimiento que pueden aparecer en cualquier seno paranasal, representando el seno esfenoidal menos del 10%. Objetivo: Presentamos nuestra experiencia de mucoceles en el seno esfenoidal. Material y método: Se obtuvieron los datos a partir de nuestra base de datos que recoge prospectivamente los casos de tumores de cabeza y cuello. Entre enero 1989 y enero 2013 se registraron 58 mucoceles en 54 pacientes, de los cuales 4 (7%) eran de seno esfenoidal. Tres pacientes eran mujeres y uno varón, con edades comprendidas entre 42 y 61 años. Todas las lesiones fueron estudiadas con endoscopia nasal, tomo-grafía computarizada y resonancia magnética. Resultados: Tres pacientes presentaron un antecedente quirúrgico de seno paranasal. El síntoma más frecuente fue la cefalea (3 pacientes de 4). Dos pacientes presentaron diplopia y uno pérdida progresiva de agudeza visual, requiriendo manejo quirúrgico urgente. Todos fueron tratados con esfenoidotomía por abordaje endoscópico endonasal. Fueron dados de alta a las 48 h posteriores con antibioticoterapia. Ninguno presentó recidiva. Conclusión: Los mucoceles esfenoidales representan menos del 10% de los mucoceles nasosinusales. La pérdida de agudeza visual requiere un rápido diagnóstico y manejo terapéutico quirúrgico urgente. El tratamiento de elección es la marsupialización.

Introduction: Sinus mucoceles are benign cysts that may appear in any sinus, but only 1%-10% occur in the sphenoid sinus. Aim: We describe the cases of sphenoid sinus mucoceles seen at our centre over the last 25 years. Material and method: In a prospective review of all mucoceles diagnosed between 1989 and 2013, we identified 58 mucocels in 54 patients. Four of the 58 (7%) were sphenoid mucoceles. There were three female patients and one male, and ages ranged from 42 to 61 years. We performed an endoscopy, CT and MR in all patients to confirm diagnosis. Results: Three patients had had endoscopic endonasal surgery in the past. The presenting symptoms were headache in 3 patients, diplopia in two, and visual loss, causing blindness, in one. The patient with amaurosis requiered urgent surgery. All four patients underwent sphenoidotomy with marsupialisation by the endonasal endoscopic approach. They were discharged 48 hours later on oral antibiotics. No recurrences have been observed to date. Conclusions: Sphenoid mucocele is a rare disease, requiring prompt treatment in cases of amaurosis. Good results can be achieved with endonasal endoscopic marsupialisation.

Senos maxilares vs. implantes dentales / Maxillary sinuses vs. dental implants

Los senos maxilares son, hoy en día, parte del diagnóstico en odontología, por lo que el conocimiento de los mismos es fundamental a la hora de su observación por parte de las imágenes radiológicas y la clínica. El propósito de este trabajo es mostrar los límites de la radiología convencional en el diagnóstico sinusal y los avances que ofrece la tomografía computada en la visualización de los mismos en sus mínimos detalles, tanto en patologías como en la contemplación de los distintos tipos de rellenos en las técnicas de elevación de piso...

Actinomicosis de senos paranasales / Actinomycosis of the paranasal sinuses

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Evaluación clínica y quirúrgica de pacientes con diagnóstico de mucocele en el Instituto de Oftalmología Fundación Conde de Valenciana / Clinical and surgical evaluation of patients with mucocele in the Conde de Valenciana Ophthalmology Institute

Objetivo: Los mucoceles constituyen lesiones quísticas como resultado de una obstrucción de los senos paranasales, con el subsecuente acúmulo de secreción mucoide que conlleva un aumento de volumen en el seno paranasal, manifestándose con diversos síntomas según el seno afectado. El manejo es quirúrgico. El objetivo de este trabajo fue realizar una descripción clínica de los pacientes con diagnóstico de mucocele, así como reportar resultados posquirúrgicos mediante nuestra técnica de resección de mucocele, en pacientes operados en el Instituto de Oftalmología Fundación Conde de Valenciana, en los últimos 10 años. Métodos: Se incluyeron pacientes con diagnóstico de mucocele tratados en nuestra institución en los últimos 10 años. Resultados: Los mucoceles más frecuentes se presentaron en el seno frontoetmoidal. Ambos ojos se afectaron por igual. La edad de presentación promedio fue de 52 años, sin diferencia estadísticamente significativa entre hombres y mujeres. El tiempo de evolución antes del diagnóstico fue más corto en mucoceles frontales. El síntoma más común fue proptosis. Solo se presentó una complicación transquirúrgica en un paciente. Se presentó recidiva con nuestra técnica quirúrgica en 12% de los pacientes. Discusión: Nuestros resultados correlacionan con lo descrito en la literatura. Obtuvimos buenos resultados con nuestra técnica quirúrgica sin obliterar el seno paranasal, con una recidiva de 12% comparado con 6% descrito en la literatura. Proponemos que esta técnica es accesible para los cirujanos oftalmólogos, con pocas complicaciones en manos expertas y con buenos resultados (AU)

Purpose: Mucoceles are cystic lesions, resulting from an obstruction in the paranasal sinuses and an accumulation of mucus, causing enlargement of the affected paranasal sinus. The signs and symptoms depend on the affected sinus. Treatment consists of surgical resection. The purpose of this study was to describe the clinical presentation of patients with mucocele, and also to describe the surgical results with our mucocele resection in patients treated in our institution over the last 10 years. Methods: All patients with a diagnosis of mucocele over the last 10 years and treated in our institution were included. An analysis was performed on the symptoms, surgical technique, and results. Results: Frontoethmoidal sinus mucoceles were the most common. Both eyes were affected but with no significant statistical differences. The median age at presentation was 52 years old, with no difference between both genders. The time to seek medical attention was shorter in frontal mucoceles. Proptosis was the most common symptom. Complications during surgery were reported in just one patient. Recurrence was reported in 12% of patients. Discussion: Our results correlate with those in the literature. We reported satisfying results with our technique, avoiding sinus obliterations, with a recurrence of 12% versus 6% reported in previous studies. We believe that our technique is safe and accessible for ophthalmologists in mucoceles treatment (AU)

Pólipo esfenonasal como causa de mucocele esfenoidal: un diagnóstico a considerar / Sphenoidal sinus polips

The sphenoidal sinus mucocele is a pseudocystic lesion of paranasal cavity (CPN). These injuries are probably underdiagnosed as they may be asymptomatic or cause nonspecific symptoms. The CT scan and the MRI increase the precision of the preoperative evaluation. We present a case of sphenoid sinus mucocele in a patient of 69 years old, who was admitted at our institution with 1 month evolution of persistent headache. Clinical presentation, diagnosis and treatment of this case are discussed as well as the review of the literature...

Papel del otorrinolaringólogo en el diagnóstico y seguimiento de pacientes con vasculitis primarias / Role of the ears, nose and throat specialist in the diagnosis and follow up of patients with primary vasculitidies

Las primeras manifestaciones de algunas vasculitis ocurren en órganos de la cabeza y el cuello; sin embargo, pocos especialistas las diagnostican en forma temprana ya que las infecciones y la alergia son más comunes. Entre ellas, signos y síntomas como epistaxis, obstrucción nasal, rinorrea serosanguinolenta, dolor ardoroso en región nasosinusal, cefalea, pólipos e incluso costras nasales, pueden encontrarse en personas que viven en ciudades con altos índices de contaminación y baja humedad, en pacientes con infecciones como el escleroma respiratorio, en aquellos sometidos a radioterapia y como consecuencia de otras condiciones; sin embargo, bajo las costras pueden crecer microorganismos como Staphylococcus aureus y también pueden hallarse señales que se pueden relacionar con vasculitis activa. El otorrinolaringólogo es uno de los primeros médicos a los que acuden pacientes con estos signos y síntomas, por lo que reconocer estas manifestaciones e integrar diagnósticos más oportunos en colaboración con otros especialistas es importante. Debido a la frecuencia con la que presentan como primeros signos y síntomas los otorrinolaringológicos, seleccionamos tres enfermedades vasculíticas para este artículo: granulomatosis con poliangitis (Wegener), el síndrome de Churg Strauss y la policondritis recurrente (AU)

First manifestations of vasculitis can appear on the head and neck, still few physicians are aware of these diseases, as they are unspecific and because other conditions like infections and allergies are more frequent. Among them, signs and symptoms like epistaxis, nasal obstruction, discharge, burning pain of sinonasal region, headache, sinus polyps and crusts, the latter found in people who live in highly polluted cities with low humidity, in patients with respiratory scleroma, atrophy, those receiving local radiotherapy, and due to other conditions. Under the crusts, many infectious agents, like Staphylococcus aureus may grow and, in addition, other signs related to active vasculitis may be found. The ENT specialist is one of the first physicians visited by patients with these signs and symptoms. Their recognition is important to readily diagnose these diseases. We have selected three vasculitidies for discussion in this paper: granulomatosis with polyangiitis (Wegener), Chrug-Strauss syndrome and relapsing polychondritis, since these three diseases present initial ENT problems with high frequency (AU)

Avaliação radiográfica e tomográfica dos seios nasais de gatos com doenças sinonasais crônicas / Radiographic and tomographic evaluation of nasal sinus in ten cats with chronic sinonasal diseases

Avaliaram-se os seios nasais de 10 gatos mestiços, adultos, acometidos por afecções sinonasais, por meio de exames radiográfico e tomográfico, e descreveram-se as vantagens e desvantagens dos métodos. O grande diferencial do exame de tomografia computadorizada em relação ao exame radiográfico, na avaliação dos seios nasais, foi a detecção de alterações nos seios esfenoides e a maior facilidade em localizar a lateralidade e o grau de envolvimento de alterações dos seios frontais.

The purpose of this study was to evaluate the nasal sinus of ten adult mixed-breed cats with sinonasal diseases, using radiography and computed tomography to describe the advantages and disadvantages of the methods. In the evaluation of the nasal sinus, the advantages of the CT examination regarding the radiography had been the detection of alterations in the sphenoid sinus and the easiness in locating the side affected and the degree of involvement of the frontal sinus.

Adult Chronic Rhinosinusitis:Spectrum of Clinical Features and Management in aTertiary Health Institution and Literature Review

Background:Rhinosinusitis is defined as inflammation of the nasal and paranasal sinus mucosa.Chronic rhinosinusitis occurs when this inflammation and the symptoms persist for more than 3 months.The objective of this study was to evaluate the clinical features and management of adult chronic rhinosinusitis in a tertiary health institution and to review the literature for its current modalities of management.Methods:This is a 5-year retrospective study of all adult patients managed for clinically and radiologically diagnosed chronic rhinosinusitis at the study center.Their medical records were reviewed for essential data which included demographic data; clinical presentations; skin sensitivity test; radiologic reports and treatment offered.The data were collated and analyzed using simple descriptive statistics.Results: There were 228 patients; 97(42.54) males and 131(57.46) females with a male:female ratio of 1:1.35; age ranged between 18 - 67 years (mean =35.2).The five major presenting symptoms were nasal discharge 228(100.00); nasal obstruction 224 (98.25); equent throat hawking 189 (82.89); itching of eye; ear; nose or throat 138 (60.53) and excessive sneezing 136(59.65).About 6of the patients developed complications.Allergy accounted for the cause in 93 (40.79)patients. Maxillary antral mucosal thickening and engorged inferior turbinates were the commonest radiological features. About 51of the patients were treated with intranasal inferior meatal antrostomy with or thout inferior turbinectomy.There was recurrence of symptoms in about 18of these patients from 3 to 8months after surgery.Conclusions: Both subjective and objective measures should be employed in the diagnosis of chronic rhinosinusitis and intranasal inferior meatal antrostomy may rarely produce satisfactory clinical improvement

Meningioma primario extracraneal de senos paranasales / Intracranial meningiomas of the paranasal sinuses

Los meningiomas extracraneales son poco frecuentes y es rara su localización en los senos paranasales. Presentamos el caso de un paciente con un meningioma primario de senos paranasales. Describimos el abordaje quirúrgico realizado y revisamos la literatura actual al respecto (AU)

Extracraneal meningiomas are infrequent and their localization in the paranasal sinuses is rare. We present the case of a patient with a primary meningioma of the paranasal sinuses. We describe the surgical approach and review the current literature (AU)

Mucoceles de senos paranasales. Nuestra experiencia en 72 pacientes / Paranasal sinuses mucoceles. Our experience in 72 patients

Introducción: El tratamiento tradicional de los mucoceles paranasales consistía en la extirpación mediante abordajes externos. Desde los años noventa se ha propuesto la marsupialización endoscópica como tratamiento de elección. Exponemos nuestra experiencia en el tratamiento de estas lesiones. Material y método: Se revisaron retrospectivamente 72 historias clínicas de pacientes intervenidos de mucoceles nasosinusales entre 1980 y 2006 en nuestro centro. Se describen las características clínicas, los abordajes quirúrgicos empleados y la aparición de recidivas. Resultados: La muestra se compone de 72 pacientes con un seguimiento medio de 44 (intervalo, 13–214) meses. Se presentaron un total de 81 mucoceles, de los que el 44% afectaba al seno frontal o las cedillas frontoetmoidales y el 35%, a los senos maxilares. El 29% de los pacientes no presentaban factores predisponentes. El 31% de los pacientes padecían poliposis nasal; el 35%, antecedentes de cirugía nasosinusal, y el 14%, fracturas faciales previas. Se trataron endoscópicamente 48 mucoceles y mediante abordajes externos o mixtos, 33. Apareció recidiva en 7 pacientes, 2 en el grupo de pacientes tratados endoscópicamente y 5 en el grupo de pacientes tratados mediante cirugía abierta o mixta. Conclusiones: La marsupialización endoscópica es una técnica segura y con bajo índice de recidivas que encuentra como limitación relativa los mucoceles frontales laterales o con tabicación ósea significativa (AU)

Introduction: Traditional treatment for paranasal sinuses mucoceles recommended total removal through external approaches. Since the 90s, endoscopic marsupialization has been proposed as optimal surgical treatment. We present our experience in the treatment of this pathology. Material and method: A retrospective review of 72 patients treated for paranasal sinuses mucoceles between 1980 and 2006 in our ENT department was performed. We describe clinical features, surgical approaches employed and recurrence of disease. Results: The sample was composed of 72 patients with average follow-up period of 44 months (range 13–214 months). A total of 81 mucoceles were presented, with 44% affecting the frontal sinus or frontoethmoidal cells, followed in frequency by maxillary sinus mucoceles (35%). Twenty-nine percent of the patients did not present predisposing factors; 31% of patients had a history of nasal polyposis, 35% had undergone previous sinus surgery and 14% suffered previous facial fractures; 48 mucoceles patients were treated endoscopically and 33 were treated with external or combined approaches. Recurrence was found in 7 patients, 2 in the endoscopic surgery group and 5 in the external/combined surgery group. Conclusions: Endoscopic marsupialization is a safe approach with a low rate of recurrence. The endoscopic approach may be unsuitable for frontal lateral sinus mucoceles or those with significant bone blockage (AU)