Frontal sinus mucocele – an unusual cause

A mucocele of the paranasal sinuses is a slowly developing, benign and secretion-filled mass that can lead to thinning or even loss of the adjacent bony structures due to progressive pressure build-up. The cause is usually an obstruction of outflow into the nasal cavity. A 61-year-old male patient presented with fluctuant and soft palpable swelling frontally that had been present for several weeks. The patient’s history included a fracture of the anterior frontal sinus wall in an accident in 2010, which was treated by plate osteosynthesis. Endonasal endoscopic examination revealed unremarkable findings. A 1 x 1 cm fluctuating swelling with slightly reddened dermis was detected in the area of the former surgical scar. For further diagnosis, a CT scan and an MRI of the paranasal sinuses were performed. A mucocele of the frontal sinus with per continuitatem osteolytic destruction of the cranial dome frontal paramedian with here ventrally adjacent osteosynthesis plate as well as thinning of the posterior wall of the frontal sinus with slight pelottization of the adjacent brain parenchyma was found. We performed a left frontoethmoidectomy with modified Draf III drainage, septotomy, and marsupialization of the left frontal sinus mucocele in ITN. Removal of the osteosynthesis material was omitted at the patient’s request. Diagnosis finding consists of anamnesis, clinical examination and, if necessary, subsequent imaging diagnostics. Here, the anamnesis should not be underestimated as a groundbreaking tool.

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Artikel online veröffentlicht:
12. Mai 2023