Tzu Chi Medical Journal
Volume 20, Issue 3 , Pages 201-205, September 2008

Application of an Intranasal Drill on Transnasal Endoscopic Marsupialization of Postoperative Maxillary Mucoceles

  • Yi-Che Su

      Affiliations

    • Department of Otorhinolaryngology, Taipei City Hospital, Taipei, Taiwan
    • ,
  • Hung-Meng Huang

      Affiliations

    • Department of Otorhinolaryngology, Taipei City Hospital, Taipei, Taiwan
    • Department of Otorhinolaryngology, Taipei Medical University, Taipei, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Otorhinolaryngology, Taipei City Hospital, 12, Fu-Chou Street, Taipei, Taiwan

Received 17 October 2007; received in revised form 2 November 2007; accepted 21 January 2008.

Article Outline

Abstract 

Objective

Postoperative maxillary mucoceles occur as a delayed complication of radical surgical intervention in the maxillary sinus. Conventionally, the recommended procedure for treating this entity has been the revised Caldwell-Luc operation. In this study, we present a less invasive treatment methodology which is as safe and effective.

Materials and Methods

Between January 1988 and December 2006, inclusively, 36 patients (47 sides) were enrolled in the study. Twenty-eight patients (38 sides) underwent the endoscopic marsupialization technique. Eight patients (9 sides) received a revised Caldwell-Luc operation, and this group was used as the control. Under nasoendoscopic guidance, an antrostoma was created through the inferior (29/38) or middle (9/38) meatus, and the opening was then enlarged to a diameter almost equal to that of the mucocele itself. A 15° intranasal drill was used where the medial wall of the maxillary sinus was bony.

Results

Only one patient complained of mild cheek pain after marsupialization surgery. The opening remained patent in 89.5% (34/38) of the mucoceles 1 year after the transnasal endoscopic operation. Twenty of the 38 maxillary sinus mucoceles had a bony wall between the membranous mucocele and the nasal cavity, while the wall was membranous in the remaining 18. Stoma closure was noted in four mucoceles at an average of 4.1 weeks after the operation. A statistically significant tendency for stoma closure was observed for mucoceles with bony walls adjacent to the inferior or middle meatus compared with membranous ones.

Conclusion

The transnasal approach using a powered instrument has the advantage of decreased postoperative suffering. Based on the results of this study, it appears reasonable to suggest that this is a useful treatment method for a unilocular mucocele adjacent to the medial wall of the antrum.

Keywords:  Endoscopic surgery , Maxillary mucocele , Transnasal

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PII: S1016-3190(08)60036-1

doi:10.1016/S1016-3190(08)60036-1

Tzu Chi Medical Journal
Volume 20, Issue 3 , Pages 201-205, September 2008

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