Abstract ID: 26-580
Rare case of a bilateral maxillar sinus aplasia with mucocele and atrophic rhinitis
Author: Yalda Sadeghi-Roulin Base Hospital / Institution: Private
Presentation Type: ePoster Presentation
Purpose
To report a rare case of extensive congenital paranasal sinus aplasia associated with lacrimal sac mucocele in a 28-year-old patient, and to discuss clinical manifestations and surgical implications for oculoplastic surgeons.
Methods
This is a case report, including clinical assessment, MRI imaging, intraoperative findings, and histopathological analysis.
Results
A 28-year-old patient presented with a progressive right superonasal orbital swelling evolving over 4 months, associated with mild discomfort on palpation. Clinical examination revealed a facial asymmetry with a very broad nasal bridge and midface hypoplasia. Endoscopic evaluation revealed bilateral absence of the inferior turbinates, severe crusting predominantly on the right side, septal deviation, and generalized paransal hypoplasia. Therefore, an orbital MRI was performed showing a mucocele, which was expected. More surprising was a bilateral aplasia of the maxillar sinus. The patient underwent successful endonasal drainage of the mucocele. Microbiological analysis revealed colonization with Klebsiella pneumoniae, Morganella morganii, Corynebacterium diphtheriae biovar belfanti, and Staphylococcus aureus. Postoperative evolution was favorable, with improvement of epiphora.
The association of extensive sinus aplasia, turbinate agenesis, chronic crusting, and lacrimal obstruction suggests a congenital developmental with failed sinus pneumatization. Extensive sinus aplasia may remain asymptomatic but can predispose to chronic crusting, recurrent bacterial colonization, altered nasal airflow, lacrimal drainage obstruction, and increased surgical risk due to altered anatomy.
Conclusion
Maxillar sinus aplasia is an extremely rare finding. Recognition of congenital sinus and midface malformation is essential prior to any surgery in this area including lacrimal and dental surgery. Preoperative imaging is crucial to identify the dimensions of the bone and to avoid breaching adjacent structures.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Karla | Chaloupka | University Hospital Zurich |