gms | German Medical Science

Introduction: Functional endoscopic approaches of mucoceles are of increasing account because of the development of finer instruments, drills and intraoperative image guided systems. However, it is still not clear, whether the patient really benefit in the long term follow up from the less invasive endoscopic sinus surgery of mucoceles with or without navigation.

Material and Methods: A retrospective study was perfomed at the ENT clinic of Munich´s Ludwig-Maximilians-University. 152 patients with mucoceles of the frontal sinus were included. Patients answered the SNOT20 questionnaire for evaluation of symptoms and quality of life after sinus surgery. The mean follow up time was 7.4years.

Results: Surgery was done in 67% through an endonasal approach, in 22% through a combined endo- and extranasal approach and in 11% exclusively extranasal. Image guided navigation was used in 40% of all cases. After the surgery 40% of patients reported a deterioration or stagnation of some symptoms. Disimprovement of symptoms (i.e. hyposmia, diplopia, sinu-nasal pressure and rhinorhea) was mostly monitored in the group of revision surgery. The group of endonasal approach with navigation reported the best postoperative quality of life and the least symptoms.

Conclusion: In most cases successful surgery of frontal mucoceles is possible in an endonasal approach. Quality of life and general health is better after endonasal endoscopic sinus surgery, than after an extranasal or combined approach.