Clinico-radiological considerations in the treatment of frontal sinus mucoceles.

THE PURPOSE OF THIS STUDY: To review our experience in the management of frontal sinus mucoceles with emphasis on the presentation and role of preoperative imaging in the choice of the surgical approach. MATERIAL AND METHOD: A retrospective audit of patients with frontal sinus mucoceles who were treated by the first author (HSK) was carried out. All patients had a diagnosis of frontal sinus mucoceles confirmed on clinical findings, CT and Magnetic Resonance Imaging. The operative findings were also recorded. RESULTS: Fourteen patients with frontal sinus mucoceles were treated between January 2005 and June 2009. The mean age of the patients was 52.6 years (range 21-88 years). There were 9 males (64.3%) and 5 females (35.7%). The presenting symptoms of the patients in this series were periorbital swelling (35.7%), headache (35.7%), frontal swelling (21.4%) and proptosis (14.3%). The anterior table of the frontal sinus was eroded in 64.3% of patients and the posterior table in 50%. A complete intrasinus septum was found in only 14.3% of patients. One patient (7.1%) had a Type IV Kuhn cell. The operative findings were in keeping with the radiological features. CONCLUSION: The radiological features of the mucocele were crucial in the decision-making process for the choice of the surgical technique. The state of anterior and posterior table of frontal sinus, type of Kuhn cell and presence of a complete intrasinus septum all influence the choice of surgical approach.