Management of frontal sinus mucoceles with posterior table erosion in the pretransplant cystic fibrosis population

C. Arturo Solares, Martin J. Citardi, Marie Budev, Pete S. Batra

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Chronic rhinosinusitis has been described as a universal finding in cystic fibrosis (CF). Much of the literature has focused on pediatric population with a relative paucity of data on adult CF patients. In this report, we review our experience with management of frontal sinus mucoceles with posterior table (PT) erosion diagnosed by imaging in asymptomatic adult CF patients presenting for pretransplant evaluation. Study design: Retrospective chart analysis. Materials and methods: Adult CF patients presenting with frontal sinus mucoceles from January 2003 to December 2005 comprised the focus of the study. Charts were reviewed for age, sex, clinical presentation, culture results, complications, and outcome. Results: Fifty-nine CF patients undergoing lung transplant evaluation were seen in the outpatient rhinology clinic. Among these, 3 patients presented with asymptomatic frontal sinus mucoceles with PT erosion. The average age was 28.7 years (range, 23-38 years) and male-female ratio was 1:2. Two patients were managed with computer-aided endoscopic frontal sinusotomy during the pretransplant period. In the third patient, surgery was performed post transplantation when the patient was clinically stable. Intraoperative cultures grew Pseudomonas aeruginosa in all cases. No intraoperative surgical complications were encountered. One patient required overnight ventilatory support and was extubated successfully after 24 hours. Endoscopic patency of the frontal sinusotomy was confirmed at mean follow-up of 12.7 months (range, 4-22 months). Conclusions: This preliminary report describes asymptomatic frontal sinus mucoceles with PT erosion in CF patients presenting for transplant evaluation. A high index suspicion must be maintained to avoid an inordinate delay in diagnosis given the potential risk of intracranial complications with this clinical entity.

Original languageEnglish (US)
Pages (from-to)110-114
Number of pages5
JournalAmerican Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume28
Issue number2
DOIs
StatePublished - Mar 1 2007

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Mucocele
Frontal Sinus
Cystic Fibrosis
Population
Transplants
Intraoperative Complications
Ambulatory Care Facilities
Pseudomonas aeruginosa
Retrospective Studies
Transplantation
Pediatrics

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Management of frontal sinus mucoceles with posterior table erosion in the pretransplant cystic fibrosis population. / Solares, C. Arturo; Citardi, Martin J.; Budev, Marie; Batra, Pete S.

In: American Journal of Otolaryngology - Head and Neck Medicine and Surgery, Vol. 28, No. 2, 01.03.2007, p. 110-114.

Research output: Contribution to journalArticle

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abstract = "Background: Chronic rhinosinusitis has been described as a universal finding in cystic fibrosis (CF). Much of the literature has focused on pediatric population with a relative paucity of data on adult CF patients. In this report, we review our experience with management of frontal sinus mucoceles with posterior table (PT) erosion diagnosed by imaging in asymptomatic adult CF patients presenting for pretransplant evaluation. Study design: Retrospective chart analysis. Materials and methods: Adult CF patients presenting with frontal sinus mucoceles from January 2003 to December 2005 comprised the focus of the study. Charts were reviewed for age, sex, clinical presentation, culture results, complications, and outcome. Results: Fifty-nine CF patients undergoing lung transplant evaluation were seen in the outpatient rhinology clinic. Among these, 3 patients presented with asymptomatic frontal sinus mucoceles with PT erosion. The average age was 28.7 years (range, 23-38 years) and male-female ratio was 1:2. Two patients were managed with computer-aided endoscopic frontal sinusotomy during the pretransplant period. In the third patient, surgery was performed post transplantation when the patient was clinically stable. Intraoperative cultures grew Pseudomonas aeruginosa in all cases. No intraoperative surgical complications were encountered. One patient required overnight ventilatory support and was extubated successfully after 24 hours. Endoscopic patency of the frontal sinusotomy was confirmed at mean follow-up of 12.7 months (range, 4-22 months). Conclusions: This preliminary report describes asymptomatic frontal sinus mucoceles with PT erosion in CF patients presenting for transplant evaluation. A high index suspicion must be maintained to avoid an inordinate delay in diagnosis given the potential risk of intracranial complications with this clinical entity.",
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