Open AccessGaint frontal sinus mucocoele with intracranial extension and Orbital displacement in an elderly Nigerian
Author(s) -
FO Arole,
AA Olaitan,
Olawunmi Adedoyin Fatusi
Publication year - 2004
Publication title -
west african journal of medicine
Language(s) - English
Resource type - Journals
ISSN - 0189-160X
DOI - 10.4314/wajm.v21i3.28047
Subject(s) - medicine , forehead , frontal bone , frontal sinus , anterior cranial fossa , enucleation , coronal plane , surgery , mucocele , skull , sinus (botany) , orbit (dynamics) , occiput , displacement (psychology) , exophthalmos , radiology , psychology , botany , biology , engineering , psychotherapist , genus , aerospace engineering
Mucocoele of the frontal sinus presents with initial sign of forehead swelling in about 10% of cases, and cases with huge intracranial extension have been reported to be rare. We present a case of a giant frontal sinus mucocoele with intra-cranial and intra-orbital extensions exerting a mass effect on the anterior cranial fossa in a 78 year old Nigerian female with resultant forehead swelling, proptosis and total blindness of the left eye. Diagnosis was made on clinical and radiological basis, and enucleation using coronal flap approach was done. Immediate repair of the resultant frontal bone defect was effected through the use of a curved 0.5mm stainless steel wire fixed in 3 layers across the defective frontal bone over which the soft tissues of the forehead were undermined for primary closure on sound bone. This approach was considered more appropriate than a split rib graft in view of the patient's age. No evidence of recurrence was recorded during a one-year post-surgery follow-up, suggesting that mucocoele, regardless of size can be treated with conservative surgical approach provided all cystic lining and mucocoele are removed.