sinus mucocele

Introduction

Introduction to sinus mucus cyst Sinus cyst refers to a cystic mass that originates in the sinus or originates from the tooth or root and develops into the maxillary sinus. The sinus mucinous cyst is the most common sinus cyst. More often in the ethmoid sinus, followed by the frontal sinus, the maxillary sinus is less common, the primary is rare in the sphenoid sinus. The disease is more common in young and middle-aged people, and children under the age of 10 do not suffer from this disease. The disease is mostly unilateral. Increased cysts can affect other sinuses. Cysts can develop secondary infections into abscesses, which are extremely dangerous. Perform a sinus cyst resection and establish a wide passage between the affected sinus and the nasal cavity to facilitate drainage and prevent recurrence. The ethmoid cyst of the ethmoid sinus is performed by external sinus sinus scraping. The frontal sinus or frontal sinus mucinous cyst is treated with nasal orbital sinus or frontal sinus sinus. Sphenoid sinus mucinous cysts may be open intranasally or extranasally, but it is not appropriate to scrape the sinus mucosa to avoid damage to the skull base, optic nerve, internal carotid artery and other important parts, just expand the sphenoid sinus opening. basic knowledge The proportion of illness: 0.025% Susceptible people: no special people Mode of infection: non-infectious Complications: brain abscess subdural abscess cerebral palsy

Cause

Causes of sinus mucus cyst

Immune response (30%):

It is believed that the natural opening of the sinus is completely blocked, and the secretion of the sinus is accumulated, so that a mucous cyst gradually forms. There are also reports of sinus obstruction, but there are still cysts. According to recent studies, this disease is caused by a series of biochemical and immune reactions caused by excessive protein content in the sinus mucosal secretions.

High osmotic pressure (30%):

The high osmotic pressure, that is, the osmotic pressure of the sinus secretion increases, absorbs water, and the pressure in the sinus increases, which in turn presses the bone wall. The mucous cyst wall, that is, the cystic membrane is thinned by compression, the ciliated columnar epithelium becomes flat, and the inflammatory cells infiltrate in the submucosal layer, sometimes presenting polyps or fibrotic changes. The cyst is a viscous liquid of pale yellow, tan or light green with cholesterol. The sinus bone wall becomes thin or damaged.

Activation factor (30%):

At the same time, osteoclasts in the bone marrow are acted upon by osteoclast activators of prostaglandins, parathyroid hormones and lymphocytes, causing destruction of the bone wall. The disease occurs mostly in the frontal sinus and ethmoid sinus, with fewer sphenoid sinus and minimal maxillary sinus. A huge sinus mucus cyst can invade the iliac crest and the brain. The disease is often complicated by late infection, which can be transformed into a pus cyst, which is more destructive and can cause meningitis, pus spinal fluid rhinorrhea or cavernous sinus thrombosis.

Prevention

Sinus mucus cyst prevention

1, prevention of upper respiratory tract infections, pay attention to allergic factors, timely treatment of rhinitis, sinusitis, to maintain nasal patency is the key to prevent the disease.

2, early detection, detection, treatment of sick teeth, can prevent the occurrence of odontogenic cysts.

3, the disease is completely removed by intranasal or extranasal approach cysts, establish sinus nasal cavity drainage. Tooth-derived people still need to remove the diseased teeth and can be cured.

Complication

Sinus mucus cyst complications Complications, brain abscess, subdural abscess, cerebral palsy

After the mucinous cyst is infected, it becomes a pus cyst. In the sphenoid sinus and frontal sinus cysts, such as sinus wall bone damage absorption, can expand into the skull, easy to be complicated by various intracranial infections (such as epidural abscess, subdural abscess, brain abscess). The frontal sinus cyst, such as self-rupture drainage, can form a frontal sinus with balloon swelling and brain accumulation. There have also been reports of giant sinus mucinous cysts, and cerebrospinal fluid rhinorrhea and cerebral palsy after surgery.

Symptom

Symptoms of sinus mucus cysts Common symptoms Mucinous cysts, tears, diplopia, visual impairment, eyeballs, eye muscle paralysis

1. Pain: There is no discomfort in the early stage. Afterwards, the mucous cyst gradually increases, and the wall is compressed, which can cause headache.

2. Double vision: The cyst occurs in the ethmoid sinus and the eyeball shifts outward. The eyeball of the frontal sinus shifts outward and downward. If it protrudes into the iliac crest, the eyeball can be displaced, and there are symptoms such as diplopia, tearing, and visual impairment.

3. The tip of the sacral sinus syndrome: the sphenoid sinus mucinous cyst is complicated in symptoms, can cause eyeballs to protrude, and causes blindness, eye muscle paralysis, ocular sensory disturbance and pain due to compression of the tip of the eye.

4. Endocrine disorders: If the cyst develops upward and oppresses the pituitary gland, it may cause endocrine disorders such as amenorrhea, loss of libido, and urine collapse; if the internal carotid artery is compressed, the artery may cause thrombosis.

If the sphenoid sinus mucus cyst is naturally ruptured to the front wall and the mucus is discharged into the nasal cavity (spontaneous intermittent clear nosebleed), the above symptoms can be temporarily relieved. This phenomenon has important diagnostic significance.

5. Others: In addition to the above mentioned local symptoms, pus cysts may also have symptoms such as high fever and general discomfort.

Examine

Examination of sinus mucus cyst

1. Nasal examination showed that the surface covered with mucous membranes was bulged in the middle nasal passage, and the middle turbinate or sputum was under pressure.

2, sphenoid sinus mucin cysts in the posterior nasal examination, the nasopharynx wall protrudes downward. In the maxillary sinus mucus cyst, the outer wall of the lower nasal passage is displaced into the nasal cavity, and the inferior turbinate is also pushed to the nasal septum to cause nasal stenosis, and even the face is raised.

3, sinus X-ray film and CT positioning examination.

4, local bulge puncture: draw a light yellow, brown or light green viscous liquid, see the cholesterol crystals under the microscope can make a final diagnosis.

Diagnosis

Diagnosis and differentiation of sinus mucus cyst

diagnosis

Local bulge puncture: draw a light yellow, brown or light green viscous liquid, and see the cholesterol-containing crystal under the microscope to make a final diagnosis.

Differential diagnosis

The ethmoid sinus and frontal sinus cysts must be distinguished from the internal iliac ciliary cyst, lacrimal sac, eyelid and nasal root tumor, cerebral palsy, and meningeal sputum. The maxillary sinus mucinous cyst should be differentiated from malignant tumors and odontogenic cysts. Symptoms of sphenoid sinus cysts are similar to pituitary tumors, skull base plasmacytoma, meningiomas, gliomas, and internal carotid aneurysms, and should be identified.

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