Paranasal Mucocele

The paranasal mucocele refers to an enlarged paranasal sinus, usually as a result of a build-up of mucus in the sinuses. The condition is rarely serious and can be treated with surgery. However, the best cure for a mucocele is prevention.

Paranasal Mucocele

What is a sinus mucocele?

A sinus mucocele is a chronic accumulation of mucus in one of the paranasal sinuses. It occurs when the excretory duct of the sinus is blocked and the secretion can no longer drain. As a result, the bone structure can deform and break due to the increasing pressure, causing mucus to leak into the eye socket. See photionary for Metatarsalgia 101.

Surgical removal of the mucus plug is the only treatment option, and painkillers and expectorant medications are also prescribed.

Causes

The mucocele in the paranasal sinuses is triggered when the entrance to the respective paranasal sinus is blocked. The cause can be a tumor or adhesions, as well as inflammation, trauma or scar tissue, as is often the case after an operation. The most common cause is delayed inflammation of the paranasal sinuses.

Since the mucus can no longer drain through the narrowed ducts, accumulations of secretions quickly form in the sinuses, which can lead to the ducts enlarging and the nasal septum thinning. The actual cause is the build-up of excessive mucus in the paranasal sinuses. In connection with a damage or disturbance of the function of the sinuses, which prevents the secretion from draining, this leads to an enlargement of the paranasal sinuses.

Symptoms, Ailments & Signs

A paranasal mucocele is characterized by initially weak pressure in the paranasal sinuses. The feeling of pressure increases with the increase in the accumulation of mucus and spreads to the eye sockets, often accompanied by flu-like symptoms, since the pathogens can no longer drain through the blocked ducts.

Later, the disease is clearly shown by the changed eyeball: due to the pressure on the sinuses, the secretion breaks through into the eye socket and pushes the eyeball forward. A first sign of this progression can be severe pressure pain between the eyeball and nasal bone.

Diagnosis & course of disease

A paranasal mucocele can be diagnosed quickly based on the symptoms and the specific complaints. Before that, however, the doctor will have a conversation with the patient and gather information about the clinical picture. The sinuses may have become inflamed more often or there are other clues that make the diagnosis easier.

An ultrasound examination enables a look at the cavities of the paranasal sinuses and shows any accumulations of mucus: the mucus appears whitish in the X-ray image and is differentiated from the free sinuses. Finally, a computer tomography (CT) provides information about the entire extent of the disease.

If it is suspected that the accumulation of mucus has already caused damage to the nasal and sinus areas, the doctor will perform a nasal reflection (rhinoscopy) and examine the paranasal sinuses with the help of a nasal endoscope. In this way, the inside of the nose can be adequately assessed in order to be able to make a final diagnosis.

A sinus mucocele develops over a period of several days. If channels in the nose are initially still permeable, the sinuses become more and more blocked as the disease progresses until they are finally completely closed. The mucus can no longer drain off and forms a kind of plug that, above a certain size, presses on the surrounding bones.

In extreme cases, this causes the bones to deform and break through. Depending on the position of the mucus plug, the secretion then flows either at eye level or into the pharynx. The course is rarely fatal, but the emergence of the pathogen brings with it further complications; sepsis and the development of additional mucoceles or polyps may occur.

Complications

As a rule, the clinical picture of the paranasal mucocele occurs as a result of an infection, so that various complications are also possible. In general, if a mucocele in the paranasal sinuses remains without any treatment by a doctor or medication, considerable complications or a much more unpleasant course of the disease can be expected.

In many cases, the affected person gets significantly worse air. This symptom intensifies significantly, especially during the night hours. Headaches, nausea, vomiting and also an elevated temperature are also possible complications that can occur in connection with a paranasal mucocele. A visit to the doctor is strongly recommended at this point, as the individual symptoms can otherwise become considerably worse.

However, if the affected person seeks medical treatment right from the start, the above-mentioned complications can be avoided at an early stage. However, if you do not undergo the appropriate treatment, you must expect the complications to worsen considerably.

When should you go to the doctor?

A persistent buildup of mucus in the nose should be presented to a doctor. If the person concerned cannot clean their nose sufficiently on their own, the help and support of a doctor should be sought. A doctor is needed for nasal speech, breathing disorders and a feeling of tightness in the nose. If you experience a runny nose, headache or problems concentrating, you should see a doctor. An unpleasant taste in the throat, a loss of appetite and a general feeling of being unwell should be checked out by a doctor.

Fatigue, sleep disorders and increased tiredness are indications of an illness. If everyday activities can no longer be carried out or if normal leisure activities are impaired, a visit to the doctor is advisable. A change in the eyeball is considered worrying and needs to be evaluated and treated by a doctor as soon as possible.

Secretions in the eye, changes in vision or a feeling of illness are signs of a health problem that requires treatment. If the symptoms increase in intensity or if new symptoms appear, a doctor’s visit is necessary. The pathogens spread and trigger an increasing deterioration in general well-being. Without medical care, the person concerned feels weak, ill and unable to fulfill his obligations.

Treatment & Therapy

A paranasal mucocele is primarily treated surgically. As part of the so-called Functional Endoscopic Sinus Surgery (FESS), the altered paranasal sinuses are treated surgically and any accumulations of mucus are removed. If only the so-called hook process is affected, an infundibulotomy is performed, an opening of the front ethmoid.

Depending on how severely the ducts have already been damaged by the mucocele, the sinuses must be closed again in the course of several operations. Depending on the findings, several access routes are possible: an endonasal operation is performed with the help of an endoscope and can be used to remove mucus growths or polyps.

Surgery through the oral vestibule is necessary when the mucocele has penetrated into the maxillary sinus. The subsequent therapy is limited to the recovery of the paranasal sinuses. Patients should initially speak only a little and cool the area around the nose. Care measures for the mucous membranes, such as the use of ointments, are also necessary. Medications are prescribed depending on the findings and severity of the sinus mucocele.

Outlook & Forecast

In general, a good outlook for the paranasal mucocele can be formulated. Complications rarely occur. In general, healing is accelerated if diagnosis is made early and treatment is started immediately. The nature of the disease necessitates surgery. For these, the general risks arise that are also known from other surgical interventions. The inflammation disappears after surgery. However, another disease can occur. This makes it necessary to remove the accumulation of mucus again.

If the patient omits or delays treatment, the mucocele can spread. It is not uncommon for the brain to be affected. The eyeball can also be displaced into a different position, causing the sufferer to lose vision. In general, treatment does not affect lifespan. Surgical scars remain, but are not conspicuous due to new procedures. The patient can go on with their regular life after healing. Disadvantages and complaints are not to be expected. Sometimes medication has to be taken for a longer period of time and care measures have to be carried out on the mucous membranes.

Prevention

To prevent a sinus mucocele, it is advisable to regularly care for the paranasal sinuses. This and general measures to strengthen the immune system can prevent the build-up of mucus in a sinus. Regular oral care prevents inflammation of the oral mucosa, while nose care prevents irritation and possible blockage of the paranasal sinuses.

Furthermore, a balanced diet helps to strengthen the intestinal flora and thereby improve the immune system. People who are prone to rhinitis and colds can prevent a mucocele by using nasal spray and care oil. Inhaling loosens mucus in the nasal passages, thereby preventing the sensitive ducts from becoming blocked and a mucocele developing in the paranasal sinuses.

Aftercare

As a rule, paranasal mucocele does not require long-term follow-up care. Patients can return to their everyday lives after surgery. The symptoms subside after a short time. However, the disease can recur. It is therefore advisable to take preventive measures. A healthy diet and regular oral care ensure that the paranasal mucocele stays away permanently.

The treating doctor informs his patient about appropriate behavior. The implementation of preventive aftercare is the responsibility of the patient. If the course of the disease is unfavorable, temporary long-term treatment may be necessary. Those affected must then accept further therapeutic measures. The main thing is to prevent complications.

This allows the paranasal mucocele to spread to the brain. Loss of vision cannot be ruled out. Depending on the degree of severity, the doctor and patient agree on a rhythm of presentations. Computed tomography has established itself as reliable proof of progress. Drug treatment is standard. If necessary, the follow-up also includes another operation.

After a sinus mucocele, patients should not take symptoms suggestive of the flu lightly. Another focus of inflammation may have developed. To avoid complications, going to the doctor is inevitable.

You can do that yourself

As a rule, the paranasal mucocele is treated surgically. Depending on the extent of this operation, it is important that the affected patients speak little after the procedure and cool the area around the nose. So-called cool pads, which are available in medical supply stores or pharmacies, are ideal for cooling. It is important to wrap the cooling pad with a hand towel or tea towel beforehand so that the pad does not come into direct contact with the skin. Otherwise cold burns could occur.

The freshly operated nose benefits from regular care. For this purpose, ointments are used which have been prescribed or recommended to the patient by the doctor. Another way to care for the nasal mucous membranes is to rinse the nose with salt. Both the nasal douche and the associated rinsing salt are available in pharmacies and drugstores. Oral hygiene is also very important for patients with a mucocele in the paranasal sinuses, since the nose and mouth are connected and inflammations could otherwise spread to each other.

In order to avoid infections, colds and colds, the patient’s immune system must be strengthened. This is done through a diet rich in vitamins and minerals, sufficient sleep and plenty of exercise in the fresh air.