Endoscopic treatment of odontogenic maxillary mucopyocele

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Abstract

Introduction

Mucopyocele is a term used to describe a mucocele that gets secondarily infected by pyogenic bacteria and develops pus.

Aim

This article aimed to evaluate endoscopic treatment of odontogenic maxillary mucopyocele as regards technical considerations, surgical efficacy, and prognosis.

Patients and methods

A retrospective study was conducted on patients presenting with odontogenic sinusitis complicated with maxillary mucopyocele. A total of 12 patients were included in this study. All patients underwent endoscopic sinus surgery in the form of uncinectomy with wide middle meatal antrostomy to completely expose the medial mucopyocele wall in anterior, posterior, and inferior directions. In three patients with ethmoidal extension, complete ethmoidectomy was performed extending the procedure to be partial medial maxillectomy. Postoperatively, all patients were given topical corticosteroid spray, nasal douches, oxymetazoline hydrochloride spray, and antibiotics.

Results

This series included 12 patients with maxillary mucopyocele, eight male and four female, with age ranging from 21 to 45 years. History of ipsilateral dental procedure was detected in all cases. Postoperatively, all patients showed complete resolution of nasal obstruction, nasal discharge, and facial pain. No major postoperative complications or recurrence were encountered. Nasal examination showed complete improvement with minimal crustations and granulations, which relieved with medical treatment. Postoperative computed tomography evaluation revealed significant improvement on comparison with preoperative computed tomography in all patients.

Conclusion

Incidence of iatrogenic odontogenic maxillary sinusitis and mucopyocele is increasing because of wide use of odontogenic procedure violating Schneiderian membrane. Complete removal of the mucopyocele wall with wide drainage middle meatal antrostomy is crucial for treatment. Endoscopic surgery for maxillary odontogenic mucopyoceles is an effective treatment modality with a higher success result and without recurrence.

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