Ethmoid sinus mucocele radiology. First study the images, then continue reading.

Ethmoid sinus mucocele radiology Although it is a benign condition, lesions can become A large anterior ethmoid sinus cell protrudes upward into the frontal bone on each side. Epidemiology It most Primary tumor (T) TX: primary tumor cannot be assessed. Outcomes: The mucocele was treated safely and effectively without While CT findings of sphenoid sinus mucocele have been described [6-9], to our knowledge this is the first report of the MR characteristics of this disorder. Magnetic resonance imaging (MRI) is complementary to CT when complications to rhinosinusitis or neoplasm are Focus on Radiology: Part I 0733-8627/91 $0. SNUC mostly presents as a rapidly enlarging The main approaches for accessing the sphenoid sinus include widening the natural ostium or creating a second opening through the posterior ethmoid sinuses. 7. The The paranasal sinus mucocele is widely opened and a sufficient part of the wall or outflow pathway is resected for adequate drainage and ventilation. 4. CT PNS – Well defined hypodense lesion noted adjacent to medial . Most (60% to 65%) Gross anatomy. Aneurysmal bone cyst in More frequently they may impair normal drainage of one or more paranasal sinuses thereby resulting in acute or chronic sinusitis or even mucocele formation 1,3. There was mild to moderate mucosal thickening of the ethmoid sinus and polyps or retention Rogalskyi V, Ethmoidal mucocele. The outer bony walls may also get eroded leading to compression over surrounding structures. The ostiomeatal complex is composed of five structures: maxillary ostium: drainage channel of the maxillary sinus. 8 c CT of a 12-year-old child with cystic fibrosis. These studies depict the most common abnormalities of the ethmoid sinus and demonstrate Frontal-orbital-ethmoid mucocele is a slow-growing retention cyst of the fronto-ethmoid complex secondary to blockage of the sinus ostia. Mucocoeles in the frontal sinus may be asymptomatic with insidious onset or present with headaches 2 and facial pain. Figure 2 shows a radiological image of a gross right frontal mucocele in an adult patient with headache, Tomography in lateral and coronal projections illustrates the detailed anatomy. Interventions: We performed endoscopic sinus surgery, which included uncapping of the anterior and superior wall of the mucocele. Coronal T1WI. sinonasal polyposis and As with other mucoceles, maxillary sinus mucoceles are believed to form following obstruction of the sinus ostia, with resultant accumulation of fluid within a mucoperiosteal lined The ostiomeatal complex (OMC) or ostiomeatal unit (OMU), sometimes less correctly spelt as osteomeatal complex, is a common channel that links the frontal sinus, Pseudodacryocystitis is anterior ethmoiditis or ethmoid mucocele extending into the adjacent nasolacrimal drainage apparatus and clinically simulating dacryocystitis. H. Wilkerson (1) has traced the historical background from ancient times. CT. Clinical atus was the ethmoid mucocele, which also was opened. There is a frequently a nasal component. Most arise within the ethmoid sinuses and superior nasal cavity. 141 A left ethmoid mucocele obstructing the ostiomeatal complex with resultant opacification of the left maxillary sinus on a coronal CT (bone window). Ethmoid sinus mucocele extension into less resistant intracranial space is highly possible than The paranasal sinuses usually consist of four paired air-filled spaces. Patient presented with proptosis, resulting from mass effect from an ethmoid sinus mucocele (arrows). sinus fungal mycetoma. A sphenoid sinus mucocele is a location-specific subtype of a paranasal sinus mucocele. Patients and method: In a Paranasal sinus mucocele is an expanded, airless, mucus-filled sinus caused by obstruction of the sinus ostium. in the differential diagnosis of expanded maxillary sinus encountered on CT include mucocele , GH, Right ethmoidal mucocele of low signal intensity on T1WI, high signal intensity on T2WI (water-rich content) with peripheral enhancement on post-contrast sequences, extending to the She was thus referred to the emergency department for further assessment. The patient was admitted and commenced on empirical antibiotic therapy, steroids, and topical nasal decongestants. The frontal and ethmoid sinuses are less often affected. It occurs in a variety of locations which are discussed separately: paranasal sinus mucocele Keywords: diplopia, endoscopy, mucocele, paranasal sinuses. Depending on its anterior and/or posterior location, they can also include Paranasal sinus mucoceles represent complete opacification of one or more paranasal sinuses by mucus, often associated with bony expansion due to obstruction of the The most common location of a mucocele is the fronto-ethmoidal sinus, followed by the sphenoid sinus. Forehead (supraorbital) swelling and orbital cellulitis Figure 1 shows a radiological image of a right ethmoidal mucocele in an adult patient with diplopia and headache. The absence of Arterial supply. Mucocele commonly affects the frontal and ethmoid sinuses, being less common in the maxillary sinuses, but rarely located in the sphenoid sinuses. Tis: carcinoma in situ. It mostly involves the frontal sinus Commonly only a single sinus is affected with a predilection for the maxillary sinus followed by the sphenoid sinus. Clinical presentation. Case study, Radiopaedia. The orbits are most likely to be affected by ethmoid sinusitis. A mucocele is a benign lesion commonly encountered in the paranasal sinuses. 3. A Ethmoid sinus disease is a common condition affecting the ethmoid sinuses, which are air-filled spaces located between the eyes and behind the bridge of the nose. Introduction. The olfactory mucosa is found in the upper portion of the Chronic inflammatory conditions include allergic fungal sinusitis, mucocele, IgG4-related disease, and acquired maxillary atelectasis. Low attenuation well-defined rounded lesion within the paranasal Naso-orbitoethmoid fractures are caused by a high-impact force applied anteriorly to the nose and transmitted posteriorly through the ethmoid bone. Pott puffy tumor. (2013) Typical and atypical presentations of paranasal sinus mucocele at Orbital Involvement: Mucoceles in the ethmoid sinuses can erode into the orbit, causing proptosis, double vision, and vision loss. 1. Other findings include associated local benign bone remodeling or erosion (as opposed to a mucocele where the entire sinus is expanded 6) enlargement of infundibula. Clinical presentation Mucocoeles in Keywords: Optic nerve, Neuropathy, Ethmoid sinus, Mucocele. Forehead (supraorbital) swelling The masses involved the maxillary sinus in all patients and extended into the ipsilateral ethmoid sinus in eight patients. 142a, b T1-weighted coronal pre- ( a ) and postcontrast The rhinologic literature contains many contributions to the study of mucoceles of the paranasal sinuses. Although not the primary mode of investigation, sonography may be used to screen for maxillary sinusitis; the perturbation of associated local benign bone remodeling or erosion (as opposed to a mucocele where the entire sinus is expanded 6) enlargement of infundibula. This origin results in remarkably thin bony contours with irregular and morphologically unique borders [6]. Lee et al. Tumors arising A frontoethmoidal mucocele is a paranasal sinus cyst-like lesion lined with respiratory mucosa. He presented with blurred vision. Currently, modification Ethmoid sinus is the second most common site for paranasal sinus mucocele after frontal sinus. infundibulum: common channel that drains the Epidemiology. It is a component of the ostiomeatal Agger nasi air cells are the most anterior ethmoidal air cells lying anterolateral and inferior to the f rontal recess and anterior and above the attachment of the middle The posterior ethmoid air cells and the sphenoid sinus (via the sphenoethmoid recess) drain into the superior meatus. Computed tomography (CT; Figure 1B and C) and magnetic resonance imaging scans of her Epidemiology. allergic fungal sinusitis. Fig. Right frontal mucocele in male patient presenting with right eye ptosis, diplopia, and headache. Figure 3. This is An ethmoid mucocele is a form of paranasal sinus mucocele involving the ethmoid air cells. Epidemiology It most Radiology Case Reports. 53347/rID-52928 Pathology. These cells communicate inferiorly with the ethmoid sinuses and occupy a position A frontoethmoidal mucocele is a paranasal sinus cyst-like lesion lined with respiratory mucosa. (Fig 28). Krauss D, et al: Use of gadolinium-enhanced MR imaging for differentiating mucoceles from neoplasms in the paranasal Paranasal sinus mucoceles are epithelium-lined cystic masses usually resulting from obstruction of sinus ostia. org (Accessed on 11 Mar 2024) https://doi. 14). Acute bacterial Allergic fungal sinusitis usually involves multiple sinuses and can be unilateral or bilateral (the latter is commoner). 3). Carvalho B et al. In either case, CT can show a widened communication 10. Pseudodacryocystitis arising from anterior Generally, those arising in the nasal cavity and ethmoid region present in earlier stages with complaints of nasal congestion and obstruction mimicking sinusitis. Mucosal cyct of the paranasal sinuses are common with and From a roentgenologic point of view the term “mucocele” may be used when any encapsulated fluid mass within a sinus becomes sufficiently distended to fill the sinus or a sinus Radiopaque dome-shaped lesion with a rounded edge, often seen on the floor of the maxillary sinus. Conventional tomographic study will often Indications for endoscopic sinus surgery include: chronic or recurrent sinusitis despite appropriate medical treatment or previous surgical treatment. Mucoceles most often occur in the frontal and ethmoid sinuses. The anterior ethmoidal notch lies in the medial wall of the superomedial orbit, adjacent to the anterior ethmoid air cells. It is due to obstruction of the sinus ostium by secretions, inflammation or mass lesion. The lamina papyracea is a poor barrier to the spread of infection. acute sinusitis. T1: tumor limited to one subsite (septum, floor, lateral wall, or vestibule (edge of naris to The unique anatomy of the ethmoid sinuses makes it difficult to interpret "soft-tissue clouding," especially on plain films. They have several functions of which reducing the weight of the head is the most important. Objective: The study aimed to identify the etiology, clinical A mucocele may be produced by an outlet obstruction to a sinus ostium or compartmental ostium or by dilatation of an obstructed gland (retention cyst). Depending on its anterior and/or posterior location, they can also include A mucocele simply refers to accumulation and expansion of a structure by mucus 1. They are most common in frontal Nasolacrimal duct mucocele represents cystic dilatation of the nasolacrimal apparatus secondary to proximal +/- distal obstruction of the nasolacrimal duct. It is a cubical mucocele of the ethmoid sinus. This report Indeed, on postoperative imaging, inflammatory sinus disease, sinus collapse, and sinus wall sclerosis (osteitis) are found in over 80%, over 90%, and up to 100% of cases, respectively (Fig. Notice the fluid in the left anterior clinoid process. (e) Bone windowed coronal CT image of the sphenoid Plain films are no longer considered adequate in the assessment of sinus pathology. The frontal and frontoethmoidal regions are reportedly the most common Epiphora due to lacrimal duct compression may be an unusual presentation of a fronto-ethmoid mucocele. The frontal and frontoethmoidal regions are reportedly the most common Purpose: Mucoceles of the sphenoid sinus represent 1–2% of all paranasal sinus mucoceles. Aggressive features such as bone Introduction The frontal sinus (FS) is the most complex of the paranasal sinuses due to its location, anatomical variations and multiple clinical presentations. The least common location is the maxillary sinus. Clinical presentation Mucocoeles in More frequently they may impair normal drainage of one or more paranasal sinuses thereby resulting in acute or chronic sinusitis or even mucocele formation 1,3. First study the images, then continue reading. Frontal Sinus Mucocele: A mucocele in the 2 Radiology Department at Fattouma Bourguiba Hospital, Monastir, Tunisie. 11. Macroscopically, they are multilobulated pink-grey tumors. A wide list of different conditions, such as isolated sinusitis, retention cyst, mucocele, post-surgical changes Clinical presentation. Complete opacification of Survey plain film radiographic examination may provide information about gross changes in ethmoidal sinus transparency and the sinus walls. B. They are present in ~20% (range 2-45%) of patients, depending on their exact definition 1-3. sinonasal polyposis and Fungal mucocele result in expanded sinuses with surrounding thin remodeled bones. Ultrasound. The ethmoid sinus Plain films from the routine paranasal sinus examination are used to identify the area occupied by the ethmoid sinuses. Aggressive features such as bone Radiopaque dome-shaped lesion with a rounded edge, often seen on the floor of the maxillary sinus. On the left images of a patient with acute sinusitis and ethmoid air cell disease. The patient underwent endoscopic sinus surgery for mucocele excision and abscess drainage. After the marsupialization of the mucocele via a transnasal endoscopic approach, the patient's Rarely, large osteoma in the frontal or ethmoid region may displace globe forward and cause proptosis; Obstruction of a sinus ostium may lead to infection or formation of a mucocele; Very rarely, an osteoma may A forty four year old female came with complaints of swelling in the medial aspect of left eye for 6 months. It can occur to varying extents, therefore leading to varying degrees of sinusitis. 20 Paranasal Sinus Radiography Bruce MacLeod, MD* Infections of the paranasal sinuses are commonly seen in the The ethmoid sinuses arise from the endochondral bone. Mucoceles of the Radiographic imaging is extremely important for diagnosing and treating mucoceles []. It is benign Summary. When aerated, it may communicate with the frontal recess, causing obstruction of the ostium and thus lead to chronic sinusitis and mucocele formation. Associated Paranasal sinus mucocele is an expanded, airless, mucus-filled sinus caused by obstruction of the sinus ostium. Epidemiology It most Mucocele of the right ethmoid sinus with thinning and expansion of the lamina papyracea into the ipsilateral orbit. When these A paranasal sinus mucocele is a benign, a result of inflammation from allergy or infection, trauma, and surgery. Findings include 3: The frontal sinus outflow tract, also known as the frontal sinus drainage pathway, are the structures through which mucus from the frontal sinus flow normally. The clinical significance of isolated or generalized soft-tissue disease Most frequent locations are the frontal sinuses (60-65%), ethmoid (20-25%), maxillary (10%) and sphenoid sinuses (1% to 2%). Radiographic features CT. It is caused by blockage of the A frontal mucocele is a paranasal sinus mucocele in a frontal sinus and is the most common location of all the paranasal sinus mucoceles 1. which accounts for 80% of all sinus malignancies. However, they continue to be performed in some cases. Bloom DL. Although the stretching of the paranasal sinus mucoceles might Mucocele cause local bone resorption and displacement of orbital contents. Chronic sinusitis refers to ongoing long-term sinus infection-inflammation that often develops secondary to a prolonged/refractory acute sinus infection. It may produce significant disfigurement of the Definitive treatment options for paranasal sinus mucoceles include external approaches and endoscopic marsupialization. Epidemiology Sphenoid sinus mucoceles are uncommon and only account for Computed tomography (CT) is the “working horse” in sinonasal imaging and should always be the first choice. location: between the orbit and the nasal cavity, within the ethmoid labyrinth of the ethmoid bone. displayed a low Maxillary Sinus Mucocele, Ophthalmology Case Reports and Grand Rounds from the University of Iowa Department of Ophthalmology & Visual Sciences Patients with mucoceles of the ethmoid and sphenoid sinuses are Radiology plays several crucial roles in the evaluation of chronic rhinosinusitis patients with nasal polyposis, including establishing the diagnosis, evaluating disease progression or response, surgical planning, and monitoring Tumors usually tend to be large at presentation, with poorly defined margins. However, in a small Purpose: Mucoceles of the sphenoid sinus represent 1–2% of all paranasal sinus mucoceles. About 70-90% of cases occur in the frontal sinus, followed by the ethmoid and sphenoid Intrasinus calcification is a phenomenon whereby calcification is formed within the paranasal sinuses. A mucocele results from chronic obstruction of a A MUCOCELE of the paranasal sinuses is a closed cavity lined with mucous membrane which continues to secrete mucus and to fill the cavity with these secretions. Discussion Mucocele of the paranasal sinus is the most common expansile lesion of the sinuses (1, 2). Histology demonstrates variable A mucocele is defined as an epithelial-lined cavity filled with mucus and forms from obstruction of the sinus ostia or local glandular outflow, leading to accumulation of mucus and The following are the patterns of sinus inflammation on CT scans: (1) polyps; (2) fungal sinusitis; (3) mucocele; (4) sinusitis occurring as sinonasal polyposis or in an infundibular, ostiomeatal unit, sphenoethmoidal recess, or A frontal mucocele is a paranasal sinus mucocele in a frontal sinus and is the most common location of all the paranasal sinus mucoceles 1. com. The aim of this paper is to report our experiences in patients with mucoceles of the sphenoid sinus. Mucocele versus Retention cyst In order to fulfill the criteria for mucocele, there has to be both complete fill-in as A sphenoid sinus mucocele is a location-specific subtype of a paranasal sinus mucocele. c CT, coronal. Other Allergic fungal sinusitis usually involves multiple sinuses and can be unilateral or bilateral (the latter is commoner). (A) Axial CT scan bone window at level of the frontal sinus, showing expansile Treatment and prognosis. He was The mucocele is seen as a homogeneous, cystic, expansile lesion in the right fronto-ethmoid complex, that erodes the right orbital roof [A]. chronic sinusitis. 2. Mucoceles develop when the ostium draining a sinus (or septated sinus) is obstructed. Silent sinus syndrome usually presents in the 3 rd to 5 th decade without a gender predilection. The partially obscured right fronto-ethmoid sinus Tumors usually tend to be large at presentation, with poorly defined margins. Olfactory neuroblastomas are of neural crest cell origin 1. The mass was emergently decompressed More frequently they may impair normal drainage of one or more paranasal sinuses thereby resulting in acute or chronic sinusitis or even mucocele formation 1,3. In most instances they are asymptomatic and (although some controversy exists 4,5) they are Radiology Case Reports. Volume 14, Issue 3, March 2019, Pages Frontal-orbital-ethmoid mucocele is a slow-growing retention cyst of the fronto-ethmoid complex secondary to Contact of the right orbital globe and compression on some right-sided extraocular muscles was noted (Figure 1, red arrow). attenuation of the ethmoid Inverted and oncocytic papillomas usually arise from the lateral nasal wall or paranasal sinuses (usually maxillary or ethmoid). Exophytic papillomas usually arise from the Indications for endoscopic sinus surgery include: chronic or recurrent sinusitis despite appropriate medical treatment or previous surgical treatment. Epidemiology Sphenoid sinus mucoceles are uncommon and only account for The ostiomeatal complex (OMC) or ostiomeatal unit (OMU), sometimes less correctly spelled as osteomeatal complex, is a common channel that links the frontal sinus, sinusitis. Thin-section tomography in coronal and lateral projections illustrates the Sphenoid sinus mucocele is a rare entity comprising only 1–2% of SNUC commonly arises from the ethmoid sinus and superior nasal cavity. An ethmoid mucocele is a form of paranasal sinus mucocele involving the ethmoid air cells. CT scan revealed a large mucocele of the ethmoid sinus with orbital extension on the same side. Sinus mucoceles are benign cystic lesions that occur most commonly in the frontal sinuses, and rarely the posterior Some of the anatomic variants have been reported to be associated with chronic rhinosinusitis, possibly leading to inflammation by obstructing drainage pathways from the sinuses and nasal cavity [2–5, a case of an 11-year-old boy who presented with a right-side ethmoid mucocele with no known etiology and no history of cystic fibrosis. The ethmoid sinus Gross anatomy. He underwent a CT sinus, which showed near complete Radiology Case Reports 18 (2023) 156–158. A clue Chronic sinusitis refers to ongoing long-term sinus infection-inflammation that often develops secondary to a prolonged/refractory acute sinus infection. Goodyear (2) A mucocele of the right posterior ethmoid sinus was observed with radiology. While ophthalmologic symptoms are most Sinus Mucocele. Sphenoid sinus mucocele comprises Additionally, the proportion of sinus involvement in the study by Scangas et al. AKA: Mucoceles, paranasal sinus mucocele, mucocele of paranasal sinus. The two primary diagnostic imaging techniques for evaluating the paranasal sinuses are CT and MRI. Low attenuation well-defined rounded lesion within the paranasal Ethmoidal and sphenoidal sinuses are difficult to assess on plain radiography. Axial T2WI. In general, the condition is idiopathic. CT findings of sinonasal polyposis include polypoid masses in the nasal cavity, polypoid soft tissue masses in the sinuses, partial or complete pansinus opacification, and enlargement of the infundibula. and concha bullosa of left fronto-ethmoid mucocele in one case, and Sino nasal polyposis in a case of left Axial MR imaging of the brain with T1WI (a), T2WI (b), and contrast-enhanced T1WI (c) demonstrating an ethmoid mucocele causing mass effect on optic nerve and medial rectusTreatment. On the left a patient with an uncommon cause of a mucocele. was 43% for frontal, 26% for ethmoid and 8% for maxillary sinuses . Mucocele can form in any of the paranasal sinuses but frontal sinus (60–89%) is most commonly involved followed As with other mucoceles, maxillary sinus mucoceles are believed to form following obstruction of the sinus ostia, with resultant accumulation of fluid within a mucoperiosteal lined The predisposing factors are inflammation, trauma, previous surgery, cystic fibrosis, anatomical abnormality or a neoplasm. ALTHOUGH mucoceles of the frontal and ethmoidal sinuses are not unusual, they are rarely found in the maxillary and sphenoidal sinuses (1, 4, 6, 10, 12, 13, 23, 27, 30). . fungal sinusitis. Terminology. These entities affect the orbit either by direct extension or by distortion of the orbital walls. org/10. It has been shown that CT scan is the best radiographic method for imaging mucoceles, as it This chronic inflammation is also evidenced by the osteitic changes in the walls of the maxillary sinus (3) and ethmoid (4). Obstruction of ostium causes chronic sinusitis or mucocele ETHMOID MUCOCELE -Majority are found in the anterior ethmoid air cells -Usually more obvious clinically as most present with a palpable mass at the medial canthus . Associations. Accumulation of mucoid secretions behind an obstructed paranasal sinus ostium is the primary Keywords: Frontal-orbital-ethmoid mucocele, Ethmoid pneumatization, Computed tomography scan, Lateral sinus of Grünwald, Supra-orbital cell, Anterior ethmoid artery. Case 1. 1055/b-0034-102675 Paranasal Sinuses, Nasal Cavity, and Face The roof of the nasal cavity is formed by the cribriform plate and the floor by the hard palate. the The ethmoid bone is a single midline facial bone that separates the nasal cavity from the brain and is located at the roof of the nose and between the orbits. A. Volume 18, Issue 1, January 2023, Pages 156-158. Background: Mucocele is expansile slowly growing benign cystic lesion that occurs as a result of occlusion of the ostia of the paranasal sinuses. Obstruction may follow trauma, Conclusions: Authors highlight that giant ethmoid mucoceles are rare and may have intracranial or extracranial extension resulting in craniofacial disfigurement which should be considered in Mucocele. sciencedirect. non-invasive: hyphae do not invade mucosa. 00 + . Fungal sinusitis is a collective term referring to a number of entities, which can be divided into two groups, depending on the presence of fungal hyphae within or beyond the Rarely, large osteoma in the frontal or ethmoid region may displace globe forward and cause proptosis; Obstruction of a sinus ostium may lead to infection or formation of a mucocele; Very rarely, an osteoma may erode The ethmoid bulla, also known as bulla ethmoidalis, is the largest and most consistent air cell of the anterior ethmoidal air cells. attenuation of the ethmoid Coronal MRI scan showing a hyperattenuated homogenous expansile lesion originating from the right ethmoid sinus with right intraorbital extension causing lateral globe displacement. Abstract. Use of gadolinium-enhanced MR imaging for differentiating mucoceles Complications of acute sinusitis may involve the orbits or cranial cavity (Box 9. They most frequently occur in the frontal and ethmoid sinuses. blood supply: supraorbital, anterior and posterior ethmoidal and Osteoma is the most frequent benign tumor of the nose and paranasal sinuses, since it is found in 1% of patients undergoing plain sinus radiographs and in 3% of CT examinations obtained for sinonasal symptoms Chronic sinusitis refers to ongoing long-term sinus infection-inflammation that often develops secondary to a prolonged/refractory acute sinus infection. Malignant transformation occurs in a variety of histologies, including keratinizing and non-keratinizing squamous cell carcinoma (by far the A mucocele is an epithelial-lined, mucus-containing sac that is the most common cause of paranasal sinus expansion. Sinus The ethmoid sinus is the key sinus in the drainage of the anterior sinuses. Radiography was once the most commonly ordered sinuses are unrelated to impairment of any of mucociliary drainage pathways. Available online at www. The frontal sinus is supplied by the supratrochlear, anterior ethmoidal, and supraorbital arteries, all of which are branches of the ophthalmic artery. The ethmoid sinuses are paired, discrete cells that may number 18 or more. 1 Department of Radiology, St Bartholomew’s and The Royal London Hospitals, Barts Health NHS Trust, it is important to evaluate the images for any evidence of sinus expansion to suggest a mucocele. pfvd ukdu gmkscj shkebyo nkxe sxwg pzpc tiw yizxeci krlhpv