2010 Volume 126 Pages 15-18
Mucoceles of the paranasal sinuses can grow progressively to compress the bony structure of the skull base, which eventually leads to intracranial extension. The management and follow-up such a case will be presented. A 54-years-old female had massive intracranial extension of the paranasal sinus mucocele. The initial symptom was left visual loss and headache. Diagnostic images revealed massive soft density of the frontal and ethmoid sinuses with a wide defect of the orbital bone and the base of the skull with the high intensity seen in both T1 and T2 signals. These findings suggested a fronto-orbital-ethmoid mucocele with extension of the skull base. The mucocele was safely marsupialized via the endonasal endoscopic approach. Although the dura of the skull base was extensively exposed, no cerebrospinal fluid leak or herniation occurred. There was no deviation of the brain substance in the CT or no cranial nerve deficit during a long-term follow-up. We believe that the endonasal endoscopic approach with the marsupialization technique is the most recommendable option for huge mucoceles because of the minimally invasive, safe and effective method.
