Lombardo Nicola, Ferrise Pierpaolo, Piazzetta Giovanna Lucia, Bruzzichessi Donatella, Testa Domenico, Viola Pasquale, Pelaia Corrado, Motta Gaetano
Ann Ital Chir. 2018 Apr 9;7:S2239253X18028190.
Maxillary sinus mucocele is an unusual clinic entity (incidence of 3-10%), represented by mucous secretion lined by respiratory stratified pavemented epithelium and its origin is mainly secondary to infections, inflammations, surgery, trauma or neoplasia.
We present a case of maxillary sinus mucocele. Subject of the study is a 74 aged patient referring positive anamnesis for nasal cavity surgery. His symptoms appeared six months ago and he complainted vertical ocular diplopia and ocular tension sensation, without rhinologic complaints. Oculistic examination confirmed an isolated left inferior rectus palsy, and CT showed mucous secretion occupying left maxillary sinus, with bone erosion to the orbital floor until orbital muscles. MRI is the gold standard for differential diagnosis with neoplastic lesions but the patient refused to perform this radio-diagnostic exam. He underwent to Endoscopic sinus surgery, consisting in middle meatal antrostomy and removal of the mucocele. Four months later the endoscopic follow-up showed regular maxillary cavity and regular ocular motility.
In our opinion the rebuilding of the eroded bone is not mandatory if the integrity of the maxillary upper wall mucosa is respected, and antrostomy with drainage allows to recover ocular and paranasal sinus function. KEY WORDS:, Diplopia, Endoscopic sinus surgery.
上颌窦黏液囊肿是一种不常见的临床病症（发病率为3% - 10%），由呼吸性复层扁平上皮衬里的黏液分泌物构成，其起源主要继发于感染、炎症、手术、创伤或肿瘤形成。
我们呈现一例上颌窦黏液囊肿病例。研究对象是一名74岁患者，有鼻腔手术的阳性既往史。他的症状于六个月前出现，主诉有垂直性眼复视和眼胀感，无鼻科相关症状。眼科检查确诊为单纯性左眼下直肌麻痹，CT显示黏液分泌物占据左上颌窦，伴有眶底骨质侵蚀直至眶肌。MRI是与肿瘤性病变进行鉴别诊断的金标准，但患者拒绝进行此项放射诊断检查。他接受了鼻内镜鼻窦手术，包括中鼻道上颌窦造口术及黏液囊肿切除术。四个月后，鼻内镜随访显示上颌窦腔正常且眼球运动正常。
我们认为，如果上颌窦上壁黏膜的完整性得到尊重，侵蚀骨质的重建并非必要，而行上颌窦造口引流术可恢复眼部及鼻窦功能。关键词：复视，鼻内镜鼻窦手术
