Endoscopic nasal surgery for mucocele and pyogenic mucocele of turbinate: Three case reports

Abstract

BACKGROUND

Cases of turbinate mucocele or pyogenic mucocele are extremely rare. During nasal endoscopy, turbinate hypertrophy can be detected in patients with turbinate or pyogenic mucocele. However, in many instances, differentiating between turbinate hypertrophy and turbinate mucocele is difficult. Radiological examinations, such as computed tomography (CT) or magnetic resonance imaging (MRI), are essential for the accurate diagnosis of turbinate mucocele. Herein, we report three cases of mucocele or pyogenic mucocele of turbinate, including their clinical presentation, imaging findings, and treatments, to help rhinologists understand this condition better.

CASE SUMMARY

Three cases of turbinate and pyogenic mucocele were encountered in our hospital. In all patients, nasal obstruction and headache were the most common symptoms, and physical examination revealed hypertrophic turbinates. On CT scan, mucocele appeared as non-enhancing, homogeneous, hypodense, well-defined, rounded, and expansile lesions. Meanwhile, MRI clearly illustrated the cystic nature of the lesion on T2 sequences. Two patients with inferior turbinate mucocele underwent mucocele lining removal, while the patient with pyogenic mucocele underwent endoscopic middle turbinate marsupialization. The patients were followed up on the first, third, sixth month, and 1 year after discharge, and no complaints of headache and nasal congestion were reported during this period.

CONCLUSION

In conclusion, both CT and MRI are helpful in the diagnosis of turbinate or pyogenic mucocele. Additionally, endoscopic nasal surgery is considered to be the most effective treatment method.

Keywords: Mucocele; Pyogenic mucocele; Inferior turbinate; Middle turbinate; Concha bullosa; Case report

Core Tip: Herein, we reported three cases of turbinate and pyogenic mucocele, including their clinical presentation, imaging findings, and treatment approach. Concha bullosa was the basis of turbinate and pyogenic mucocele. In our study, nasal obstruction and headaches were the most commonly reported symptoms, which was consistent with previous studies. Computed tomography and magnetic resonance imaging are essential for the accurate diagnosis of turbinate mucocele. Surgical removal of turbinate mucocele and pyogenic mucocele is the recommended procedure.