Postoperative maxillary sinus mucocoele: risk factors for restenosis after surgery and preventive effects of mytomycin-C.

OBJECTIVE

To evaluate the clinical factors associated with restenosis after the surgery for treating postoperative maxillary sinus mucocoele and the preventive effect of topically applied mytomycin-C (MMC) on the restenosis.

METHODS

This double-blinded randomized controlled prospective study included 38 cases of postoperative maxillary sinus mucocoeles. The patients underwent inferior meatal antrostomy with or without Caldwell-Luc operation, and cotton-pledgets soaked with MMC or normal saline were applied to the antrostomy sites for 5 minutes. The degree of narrowing of the opening and its correlation with the preoperative characteristics, including age, gender, allergy, presence of polyps, interval between previous surgery and computed tomography findings were evaluated.

RESULTS

Three months after the surgery, the openings were patent in 24 cases, narrowed in 5 cases and stenotic in 9 cases. MMC application, septation of mucocoele and concurrent inflammation at the lesion side all had a significant effect on stenosis of the antrostomy site at 3 months after the surgery (p < 0.05, Chi-square test).

CONCLUSIONS

MMC has a favorable effect in preventing narrowing of the opening after surgery for maxillary sinus mucocoeles. The presence of septa in the mucocoeles or concurrent inflammation in the ipsilateral sinuses has an effect to promote restenosis.