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Recently, most frontal sinus mucoceles have been successfully managed by endonasal procedures. However, endonasal frontal sinus surgery will not be successful if the disease cannot be reached or longterm stable drainage is not established, despite opening the frontal sinus wide (with a type II or III drainage according to Draf), or prolonged stenting at the neo-ostium. In these cases an external approach is necessary. We report a patient suffering from a giant mucocele of the right frontal sinus extending into the right orbit and lateral to the right anterior cranial fossa. The wall of the mucocele was totally dissected under microscopic control with great care. The cavity in the frontal base left after the removal of the wall of the mucocele was packed with the reflected pericranium and rotated temporal muscle flap. The patient has been event free for 10 months postoperatively and will be followed up periodically.

Giant Mucocele of the Frontal Sinus Extending into the Right Anterior Cranial Fossa; A Role of External Approach and Sinus Obliteration.