The Place of Ct Scan in the Diagnosis of Frontal Mucoceles: A Report on Two Clinical Cases

Résumé fourni par la source

Introduction: Paranasal sinus mucoceles are benign and expansive lesions, related to the accumulation of mucus in an obstructed sinus cavity. The frontal mucocele is the most common, representing 60 to 89% of cases. Despite their benign nature, these lesions can lead to serious complications by extension to orbital or intracranial structures. Clinically, they can manifest as frontal swelling, orbital pain, exophthalmos or visual disturbances, making diagnosis difficult in the early stages. Computed tomography (CT) plays a central role in visualizing the lesion, assessing its extension and guiding management. In a resource-limited setting like Mali, its access remains crucial. This work illustrates the importance of CT through two clinical cases managed at Nianankoro Hospital Fomba of Segou. Methodology: This is a retrospective study of two patients treated between January 2023 and January 2025. Clinical, radiological (CT) and surgical data were analyzed. The diagnosis was based on the identification of expansive hypodense lesions of the frontal sinus with bone erosion. Both patients underwent endonasal surgery. Clinical observations: The first patient, 45 years old, presented with a left frontal swelling that had been evolving for 10 years. CT scan revealed a frontal mucocele with bone lysis and early intracranial extension. Endonasal surgery resulted in a favorable outcome without recurrence. The second patient, 35 years old, followed for chronic frontal sinusitis, presented with right exophthalmos. CT scan showed a mucocele compressive fronto -ethmoidal without bone rupture. The surgical intervention resulted in regression of the signs. Conclusion: These cases illustrate the clinical diversity of frontal mucoceles and confirm the diagnostic value of CT, essential for early and effective management.

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