Maxillary sinus mucoceles is a paranasal sinus mucocele in a maxillary sinus and is the least common location of all the paranasal sinus mucoceles.
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Pathology
As with other mucoceles, maxillary sinus mucoceles are believed to form following obstruction of the sinus ostia, with resultant accumulation of fluid within a mucoperiosteal lined cavity. With ongoing mucus production and accumulation within the mucocele, it enlarges gradually, resulting in erosion and remodeling of the surrounding bone.
Radiographic features
CT
- homogeneously low attenuating expansile lesion within a maxillary sinus
- does not enhance with contrast
- may demonstrate bony erosion of the sinus walls
- used for surgical planning
MRI
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T1
- water-rich content: low signal (most common)
- protein-rich content: high signal
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T2
- water-rich content: high signal (most common)
- protein-rich content: low signal
- may look like an air-filled sinus in advanced disease
- T1 C+ (Gd): enhancement, if present, only occurs at the periphery
- DWI: variable
Treatment and prognosis
Maxillary mucoceles are slow growing benign lesions but have been reported to be locally aggressive and sometimes cause bony destruction resulting in orbital and dental symptoms 3. Reported treatment options include marsupialization, Caldwell-Luc procedure and endoscopy 1.