Treatment of Frontal Sinus Giant Mucocele by Endoscopy and Trephination： Case Report

Paranasal sinus mucocele is slowly expanding lesion of benign entity caused by retention of mucous secretions in the sinus. Frontal sinus is the most common site and if frontal mucocele extends to orbital and intracranial structures, orbital symptoms such as pain, swelling, exopthalmos, diplopia, and loss of vision are mainly presented. The surgical treatments of paranasal sinus mucocele are divided into external and transnasal approach, and transnasal approach by nasal endoscopy is recently the major choice for surgical treatment of paranasal sinus mucocele. But, nasal endoscopic marsupialization by transnasal approach in frontal sinus mucocele has limitations in some cases because of difficulty of approach and risk of recurrence. Especially, in giant mucocele of frontal sinus, which has orbital symptoms, wide excision by external approach had been recommended acc-ording to past reports. We had the excellent surgical result by bimanual methods using nasal endoscopic marsupialization and endoscopic approach through external trephination in giant mucocele of frontal sinus. (J Clinical Otolaryngol 2007;18:117–121)