Prostaglandin synthesis in the pathogenesis of fronto-ethmoidal mucoceles

The fronto-ethmoidal mucocele is a rare condition capable of expansion and erosion of bone. Its etiology is attributed to obstruction of the fronto-nasal duct and inflammation. To elucidate the role of inflammation, mucocele fragments and fibroblasts cultured from them were examined in vitro to assess prostaglandin E2 synthesis. The cultured fibroblasts when stimulated with mononuclear cell culture supernatant produced significant levels of prostaglandin E2 and collagenase, compared with normal frontal sinus mucosa fibroblasts removed at craniotomy. These significantly elevated mucocele levels of prostaglandin E2 (p = less than 0.001) suggest that lining fibroblasts are a major source of bone-resorbing factors, acting under the stimulus of lymphocytes and monocytes and which operate at the mucocele-bone interface, facilitating expansion. This situation closely parallels that already established in odontogenic cysts.