Abstract
Objective: 1) Understand the factors affecting outcomes in surgery for fronto-ethmoidal mucocoeles (FEM). 2) Add to the senior author’s experience to the existing literature regarding the management of FEM.
Method: A retrospective study of patients treated by the senior author from 1995 to 2010 was undertaken. A patient database was used to identify those who had endoscopic surgery for FEM. Patient notes and operative records were reviewed and assessed for variables that may affect outcome after surgery.
Results: A total of 40 patients underwent 44 endoscopic procedures for treatment of FEM. The mean age was 46.3 years, and mean follow-up time was 74.9 months. Two patients (5%) had head trauma as an etiological factor. A total of 28 Draf IIa procedures, 13 Draf IIb, and 3 Draf III procedures were performed. Three patients had surgery combined with open approaches. Two patients had bilateral surgery, and 2 patients required revision surgery: one for restenosis after a Draf IIa procedure (1/28) and one for disease recurrence. Stenosis was found in a further 3 patients who had Draf IIb surgery (3/13).
Conclusion: The current series represents one of the largest for the endoscopic management of FEM. Endoscopic approaches are suitable for all but the most lateral of mucocoeles. The most common complication, restenosis of the frontal recess, was more likely following Draf IIb procedures (23%) than Draf IIa (3.6%) procedures.
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