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J Craniofac Surg. 2014 Nov;25(6):2008-12. doi: 10.1097/SCS.0000000000000074.

Frontoethmoidal mucocele following pediatric craniofacial surgery.

Author information

1
From the *Royal National Throat Nose and Ear Hospital; and †The Craniofacial Unit, Great Ormond Street Hospital for Children; and ‡Department of ENT-Head & Neck Surgery, North West London Hospitals NHS Trust, London, United Kingdom; §Craniofacial Unit, Westmead Children's Hospital, Sydney, New South Wales, Australia; and ∥Department of Radiology, Imperial Healthcare NHS Trust; and #Department of ENT-Head & Neck Surgery, Guy's & St Thomas' NHS Foundation Trust, London, United Kingdom.

Abstract

BACKGROUND:

Mucoceles occur as a result of accumulation and retention of mucous secretions in a paranasal sinus and are uncommon in the pediatric age group. Persistent or intermittent closure of its ostium through a variety of causes, including previous surgery, is implicated in etiology. The authors report 2 cases of frontoethmoidal mucocele that followed box osteotomies for the treatment of orbital dystopia, with medical literature review and discussion of possible causal factors and events.

METHODS:

Case histories and radiological imaging are presented on 2 patients presenting with frontoethmoidal mucoceles following craniofacial surgery. Both had transcranial craniofacial techniques where all orbital walls and globe are moved en bloc as a "box."

RESULTS:

Patient 1, a 12-year-old male patient with Crouzon syndrome, developed mucoceles within 18 months of monobloc distraction surgery and box osteotomies. This was successfully marsupialized with a combined external and endoscopic surgical approach. The second patient, a 15-year-old boy with previously corrected right-sided facial cleft, developed mucocele 9 years following box osteotomies; this was successfully managed by endoscopic drainage. Of 3 other patients having similar box osteotomies in our unit, no other mucoceles were noted as complications.

CONCLUSIONS:

Mucoceles are a rare complication of craniofacial surgery, and literature review confirms a paucity of reports. Only 1 case has previously been alluded to of mucocele complicating box osteotomy for orbital dystopia. Our 2 cases illustrate and highlight a successful management approach in a multidisciplinary craniofacial unit.

PMID:
24481162
DOI:
10.1097/SCS.0000000000000074
[Indexed for MEDLINE]

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