Telescopic extracranial approach to frontal mucoceles with intracranial extension

Traditionally, frontal mucoceles were treated with open obliterative procedures such as collapse of the forehead soft tissues into the sinus or the more cosmetically appealing osteoplastic flap technique. When a frontal mucocele expands intracranially, these surgical procedures become difficult and with higher risk of cerebrospinal fluid leak and/or meningitis. In cases of a mucocele that extends both intracranially and anteriorly into the soft tissues, osteoplastic flap procedure may not be possible. We present our experience with telescopic intranasal surgery for the treatment of frontal mucocele with intracranial extension. The technique, which is based on intranasal marsupialization and stenting, was used in four patients with large mucoceles eroding into the cranium and the anterior soft tissues. The results were excellent and the patients are free of disease 1 to 4 1/2 years after surgery.