Clinicopathologic, Ophthalmic, Visual Profiles and Management of Mucoceles in Blacks. RESULTS

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A total of 20 patients were involved in the study. These included nine (45%) males and 11 (55%) females with a male:female ratio of approximately 1:1. The mean age at presentation was 32.8 years, standard deviation 22.07 and range 1-75 years. The age and sex distribution of these patients is shown in Table 1. Mucoceles commonly involved more than one sinus on the same side. The sinuses commonly involved were the frontoethmoidal, frontal sinus and the maxillary sinuses. No bilateral case of mucocele was encountered in the study.

Table 1. Age and sex distribution of 20 patients with mucoceles

Age (Years)

Males

Females Total Percent
1-10

1

1

5

10-20

3

со

6

30

20-30

1

3

4

20

30-40

2

1

со

15

40-50

1

1

2

10

50-60

>60

1

со

4

20

Total

9

11

20

100

Radiological findings in nine (45%) patients showed the classical expansive appearance of the frontal and ethmoidal sinuses with loss of the normal scalloping appearance. In others, the appearance was not well defined and was compounded by the presence of polyps in six patients. Three of the patients had destruction of the floor of the frontal sinus, one had destruction of the medial wall, while another one had posterior frontal wall dehiscence with frontal lobe abscess. Your life is worth living. Buy generic actos online

Table 2. Degree of proptosis and directions of displacement of the affected globe in 20 patients in mucoceles

Exophthalmometric Direction of
Reading Displacement
1-5 mm 3 Medial              0
6-10 mm 7 Superior            1
11-15 mm 6 Inferior              4
16-20 mm 3 Lateral              3
>20 mm 1 Inferolateral      12
Total 20 20

All the cases of mucoceles in the study had more than one (i.e., combination) of ophthalmic presentations. Sixteen (80%) patients had visual acuity of 6/4-6/9, three (15%) had between 6/9-6/18 and one (5%) patient was CF (“count fingers”) in the affected eye preoperatively. The commonest main ophthalmic presentation was proptosis, which was present in 15 (75%) patients. Proptosis was nonaxial in all cases with inferior, lateral or inferolateral displacement (Figure 1). Degree of proptosis ranged from 1-20 mm. In one patient, exophthalmometric reading was more than 20 mm. The degree of proptosis and direction of displace-ment of affected eyeball are shown in Table 2. Other presentations were squint (leading to diplopia), which was observed in one (5%) patient and epiphora in another [one (5%)] patient. Poor vision was the main problem in one (5%) patient, while in another [one (5%)] patient, the affected eye was completely immobilized. Only one (5%) patient presented with orbital cellulitis. The main ophthalmic presentations of 20 patients with mucoceles are summarized in Table 3.

Table 3. Main ophthalmic presentations in 20 patients with mucoceles

Main Feature

Number

Percent
Proptosis

15

75

Squint

1

5

Epiphora

1

5

Visual impairment

1

5

Ophthalmoplegia

1

5

Orbital cellulitis

1

5

Total

20

100

All the 20 patients had excision of mucoceles (frontoethmoidectomies). At surgery, 11 (55%) patients had combination of dehiscence of medial and/or posterior walls, and/or floor of the orbit. Of these, six (30%) patients in addition had polyps in the affected sinus. Materials evacuated were mucopurulent in 15 (75%) cases, moldy in three (15%) and cheesy in two (10%). These materials were all sent for microbiological analysis. Nine (45%) patients had intact walls. Save on your pharmacy bills. Buy generic rosiglitazone online

Table 4. Summary of pre- and postoperative visual acuities in 20 patients with mucoceles

Preoperative Postoperative
VA        Number % Number %
6/4-6/9       16 80

16

80
6/9-6/18     3 15

3

15
6/18-6/60   —

CF-LP         1 5

No LP         — 1 5
Total          20 100

20

100

The proptosis regressed spontaneously within one week of surgery in 17 (85%) patients (Figure 2). By six weeks, all the patient’s visual acuity returned to preoperative visual acuity level and complete regression of proptosis. The fourth patient with preoperative visual acuity of CF later deteriorated and became NPL (no perception of light) in the affected eye. This patient was later diagnosed and confirmed to have a concomitant non-Hodgkin’s lymphoma of the orbit. Three patients developed orbital cellulitis as postoperative complication. The pre- and postoperative visual acuities of 0 patients with mucoceles are summarized in Table 4. Make your pharmacy dollar go further and buy medication skelaxin online

Figure 1. Preoperative photograph of a 52-year-old Nigerian adult male with left frontoethmoidal mucocele

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Figure 2. Postoperative photograph of same patient

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By two months postoperatively, 17 (85%) of our patients defaulted to follow-up. The three (15%) cases that were still attending the clinic had complete regression by this time. This situation has made it difficult for us to calculate the recurrence rate. Buy sumatriptan

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