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A frontoethmoidal mucocele is a paranasal sinus cyst-like lesion (mucocele) lined with respiratory mucosa. The frontal and frontoethmoidal regions are reportedly the most common locations for paranasal sinus mucocele formation 1. They are thought to arise from obstruction of normal sinus drainage.
Mucoceles may be asymptomatic, however their ability to enlarge and erode into the adjacent intracranial and orbital regions due to ongoing mucus production and retention can cause facial pain, headaches, double vision and proptosis 1. Infection can lead to orbital cellulitis or meningitis 2,3.
- well-circumscribed expansile mass of the ethmoidal sinus with homogenous hypoattenuation of sinus contents 4
- inspissated sinus contents may appear hyperdense 5
- bony erosion/remodeling may be present
- non-enhancing with contrast
- used to identify intracranial extension or malignancy 6
- hydrated content: low signal (most common)
- inspissated content: high signal
- hydrated content: high signal (most common)
- inspissated content: low signal
- may look like an air-filled sinus in advanced disease 5
- T1 C+ (Gd): enhancement, if present, only occurs at the periphery
- DWI: variable
- mucus retention cyst
- does not completely fill the sinus
- no bony expansion
- paranasal sinus carcinoma (generally isointense or of intermediate intensity on MR imaging sequences) 5
- aspergillus sinusitis
- dermoid cyst
- osteoma (rare) 6
- 1. Scangas GA, Gudis DA, Kennedy DW. The natural history and clinical characteristics of paranasal sinus mucoceles: a clinical review. (2013) International forum of allergy & rhinology. 3 (9): 712-7. doi:10.1002/alr.21178 - Pubmed
- 2. Herndon M, McMains KC, Kountakis SE. Presentation and management of extensive fronto-orbital-ethmoid mucoceles. (2007) American journal of otolaryngology. 28 (3): 145-7. doi:10.1016/j.amjoto.2006.07.010 - Pubmed
- 3. Bakshi SS. Image Diagnosis: Frontoethmoidal Mucocele. (2019) The Permanente journal. doi:10.7812/TPP/18-288 - Pubmed
- 4. Capra GG, Carbone PN, Mullin DP. Paranasal sinus mucocele. (2012) Head and neck pathology. 6 (3): 369-72.
- 5. Van Tassel P, Lee YY, Jing BS, De Pena CA. Mucoceles of the paranasal sinuses: MR imaging with CT correlation. (1989) AJR. American journal of roentgenology. 153 (2): 407-12. doi:10.2214/ajr.153.2.407 - Pubmed
- 6. Carvalho BV de, Lopes I de CC, Corrêa J de B, Ramos LFM, Motta EGPC, Diniz RLFC. Typical and atypical presentations of paranasal sinus mucocele at computed tomography. Radiol Bras. 2013 Nov;46(6):372–5.