The Effect of Endonasal Dacryocystorhinostomy in the Paranasal Mucocele Invading Nasolacrimal Duct

Gyu Chul Chung; Seung Hwan Jo; Jae Wook Yang

doi:10.3341/jkos.2018.59.3.203

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Chung, Jo, and Yang: The Effect of Endonasal Dacryocystorhinostomy in the Paranasal Mucocele Invading Nasolacrimal Duct

Original Article

Journal of the Korean Ophthalmological Society 2018; 59(3): 203-208.

Published online: 15 March 2018

DOI: https://doi.org/10.3341/jkos.2018.59.3.203

The Effect of Endonasal Dacryocystorhinostomy in the Paranasal Mucocele Invading Nasolacrimal Duct

Gyu Chul Chung, MD^1,², Seung Hwan Jo, MD^1,², Jae Wook Yang, MD, PhD^1,²

¹Department of Ophthalmology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

²T2B Infrastructure Center for Ocular Disease, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.

Address reprint requests to Jae Wook Yang, MD, PhD. Department of Ophthalmology, InJe University Busan Paik Hospital, #75 Bokji-ro, Busanjin-gu, Busan 47392, Korea. Tel: 82-51-890-8611, Fax: 82-51-890-8722, oculoplasty@gmail.com

Received 19 October 2017 Revised 21 November 2017 Accepted 20 February 2018

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the effect of endonasal dacryocystorhinostomy in the paranasal mucocele invading nasolacrimal duct.

Methods

We analyzed 252 patients who were diagnosed with paranasal mucocele from 2006 to 2017, and found 14 patients (14 eyes) who underwent endonasal dacryocystorhinostomy in the paranasal mucocele invading nasolacrimal duct. Clinical features and surgical results of the patients were analyzed retrospectively.

Results

The origins of the mucocele were frontoethmoidal sinus (seven cases, 50%) and ethmoidal sinus(seven cases, 50%). The most common symptom from the first visit was epiphora (13 cases, 92.8%); medial canthal mass (nine cases, 64.2%) was the second most common symptom. Every patient underwent endonasal dacryocystorhinostomy with rhinology and sinus surgery according to the type, size, and severity of the paranasal mucocele. Every patient showed successful irrigation in the lacrimal canalicular irrigation test and improved epiphora 6 months postoperatively.

Conclusions

When paranasal mucocele invades the orbit, it can cause diplopia, exophthalmos, extraocular muscle movement disorders, visual impairments, and increased intraocular pressure. Furthermore, if it invades the nasolacrimal duct, it can cause obstruction of the nasolacrimal duct and result in epiphora. Based on our results, endonasal dacryocystorhinostomy was an effective primary treatment.

Keywords: Endonasal dacryocystorhinostomy, Epiphora, Ethmoidal mucocele, Frontoethmoidal mucocele, Paranasal mucocele

Figures and Tables

Figure 1

Computed tomography (CT) scan image of ethmoidal mucocele invading nasolacrimal duct (white arrow). (A) Axial view of CT scan images. (B) Coronal view of CT scan images.

Figure 2

Intranasal endoscopic view of left nasal cavity. (A) Black arrow indicates ethmoidal mucocele. (B) Left nasal cavity at 6 months after the surgery. Mucocele was successfully removed and there were no signs of recurrence.

Table 1

Munk's score

Table 2

Baseline characteristics of subjects and affected eyes

Values are presented as mean ± SD unless otherwise indicated.

IOP = intraocular pressure; CVA = corrected visual acuity.

Table 3

The presentations of mucoceles invading nasolacrimal duct

Table 4

Details of patients treated with endonasal dacryocystorhinostomy in mucocele invading nasolacrimal duct

ENT = Otorhinolaryngology-Head and Neck Surgery; M = male; F = female; Lt. = left; INE = intranasal ethmoidectomy; Fx. = fracture; INAE = intranasal anterior ethmoidectomy; Bt. = both; Rt. = right; Ant. = anterior.

Notes

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI15C1142).

^{Conflicts of Interest} The authors have no conflicts to disclose.

References

1. Beasley NJ, Jones NS. Paranasal sinus mucoceles: modern management. Am J Rhinol. 1995; 9:251–256.

2. Lund VJ, Harvey W, Meghji S, Harris M. Prostaglandin synthesis in the pathogenesis of fronto-ethmoidal mucoceles. Acta Otolaryngol. 1988; 106:145–151.

3. Haik BG, Amedee RG. Principles and practice of ophthalmic plastic and reconstructive surgery. 2nd ed. Philadelphia: WB Saunders;1996. p. 1014–1022. Vol. 2.

4. Evans C. Aetiology and treatment of fronto-ethmoidal mucocele. J Laryngol Otol. 1981; 95:361–375.

5. Moriyama H, Nakajima T, Honda Y. Studies on mucocoeles of the ethmoid and sphenoid sinuses: analysis of 47 cases. J Laryngol Otol. 1992; 106:23–27.

6. Tseng CC, Ho CY, Kao SC. Ophthalmic manifestations of paranasal sinus mucoceles. J Chin Med Assoc. 2005; 68:260–264.

7. Précausta F, Goga D, Laure B. Mucocèle ethmoïdale découverte devant un épiphora. J Fr Ophtalmol. 2013; 36:e169–e172.

8. Munk PL, Lin DT, Morris DC. Epiphora: treatment by means of dacryocystoplasty with balloon dilation of the nasolacrimal drainage apparatus. Radiology. 1990; 177:687–690.

9. Natvig K, Larsen TE. Mucocele of the paranasal sinuses. A retrospective clinical and histological study. J Laryngol Otol. 1978; 92:1075–1082.

10. East D. Mucocoeles of the maxillary antrum. Description, case reports and review of the literature. J Laryngol Otol. 1985; 99:49–56.

11. Kim SS, Kang SS, Kim KS, et al. Clinical characteristics of primary paranasal sinus mucoceles and their surgical treatment outcome. Korean J Otorhinolaryngol-Head Neck Surg. 1998; 41:1436–1439.

12. Kim JL, Yang JW. Clinical characteristics of paranasal sinus mucoceles which invade the orbit. J Korean Ophthalmol Soc. 2008; 49:562–569.

13. Barnes L. Surgical Pathology of the Head and Neck. 2nd ed. New York: CRC Press;2000. p. 445–469. Vol. 1.

14. Kennedy DW, Josephson JS, Zinreich SJ, et al. Endoscopic sinus surgery for mucoceles: a viable alternative. Laryngoscope. 1989; 99:885–895.

15. Shin HH, Lee TS, Baek SH. The comparision of surgical results of endonasal dacryocystorhinostomy in childen and adults. J Korean Ophthalmol Soc. 2006; 47:877–882.

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