Sinus Obliteration with Bone Pate and Hydroxyapatite in Treatmenting Recurrent Frontal Sinus Mucocele

Surgical treatment of frontal sinus mucocele is divided into (i) establishment of frontal sinus drainageand (ii) sinus obliteration after total mucocele removal. Advances in endoscopic sinus surgery have made it possible to manage most frontal sinus mucoceles safely and successfully by endonasal procedures, but some cases can not have stable drainage established or the specific sinus pathology is beyond the operating field of endonasal frontal sinus surgery. These cases require an external approach to remove the mucocele and sinus obliteration. We report two cases of frontal sinus mucoceles recurrent after 3 times endonasal frontal drainages. Total removal of mucocele with coronal incision and frontal sinus obliteration with autogenous bone pate and hydroxypatite were conducted. One patient remains event-free for 8 months postoperatively and the other 17 month postoperatively with no significant complications. In this report, we discuss the role of the external approach and the usefulness of sinus obliteration with bone pate and hydroxyapatite for treatment of the recurrent frontal sinus mucocele.