The surgical management of epidural mucoceles

Mucoceles of the paranasal sinuses extending into the epidural space are both uncommon and difficult to surgically manage. To best overcome the problem of recurrent disease, we have adopted a combined otorhinolaryngologic-neurosurgical approach which emphasizes removal of as much as possible of the mucocele and marsupialization, or permanent drainage, of the disease site into the nasal cavity. Recently, we have modified this procedure in selected cases to include resection of involved dura and isolation of the epidural space from the nasal cavity. The indications and results of both forms of management are now reported in ten patients.