Paranasal sinus mucoceles and its distortion of craniofacial-orbital anatomy: a narrative synthesis.

Purpose: To explore available literature on PNS mucoceles and its distortions of craniofacial-orbital anatomy with regard to orbital bony defects and ophthalmic manifestations, highlighting the PNS mucoceles that mostly result in these distortions.

Methods: A comprehensive literature search was conducted in June 2024 for available literature on the subject matter viz.; Google Scholar, PubMed and Medline, and Cochrane Library. Eligible studies were subjected to bias assessment. Extracted data from eligible studies were synthesized using narrative synthesis.

Results: Eighteen studies met the inclusion criteria. The 18 studies correspond to a total of 638 patients diagnosed with different types of PNS mucoceles, with males being the highest incidence of patients. Frontal, ethmoid, and fronto-ethmoidal mucoceles had the highest incidences (26.36%, 24.03%, and 23.29%, respectively). Orbital-bony defects, such as disruption and breach of the lamina papyracea, orbital wall erosion, and skull base erosion, were reported as the damage mostly caused by frontal and ethmoidal mucoceles. Ophthalmic manifestations such as proptosis, diplopia, ptosis, preorbital swelling, epiphora, vision problems, and exophthalmos were reported to occur in any type of the PNS mucoceles but are more common in mucoceles in the anterior sinuses.

Conclusions: The narrative review summarizes the distortion of PNS mucoceles to craniofacial-orbital anatomy. Findings from this review will help to create more awareness of the extent of possible distortion that PNS mucoceles could have on craniofacial-orbital anatomy.