An Intracranial Mucocele Secondary to an Osteoma of the Frontoethmoidal Sinuses : A Case Report

Abstract

The authors describe a case that presellted an ostemoa of the frontoethmoidal sinuses that Ied to the formation of an intracranial mucocele ． Based or】the authors ' experience in treatjng such cases and a review of the pertinent Iiterature ， the authors discuss ways to achieve a correct diagnosis and proper sしLrgical treatrnent ， so as to avoid excessively aggressive treatment for a benign lesion 、 （

Frontal Sinus Mucocele With Intracranial Extension Associated With Osteoma in the Anterior Cranial Fossa -Case Report-

“…Reconstruction of drainage route in the paranasal sinus toward nasal cavity is still controversial. 11,13) In the present case, the mucocele was totally removed en bloc successfully without drainage toward nasal cavity.…”

“…In addition, osteoma is a benign and slowly progressive tumor, so recurrence of residual osteoma is very rare. 6,11) In the present case, the dura was disrupted and repair of the anterior cranial base was required. The osteoma was partially drilled off in the epidural and subdural space to obtain the surgical space for dural repair, since the patient did not show signs of mass effect due to the osteoma such as elevation of intracranial pressure, cranial nerve palsy, or cosmetic deformity.…”

“…Mucocele with encapsulated huge tumor usually occurs secondary to obstruction of the paranasal sinus. 1,11) Long-term presence of the osteoma causes mechanical obstruction that results in the mucocele expanding toward the intracranial space with mass effect. In the present case, the huge mass of the mucocele seemed to be the cause of the convulsive episode.…”

“…[1][2][3][5][6][7][10][11][12][13][14][15][16][19][20][21][22] In most cases of coexisting osteoma and paranasal sinus mucocele, the osteoma was considered to be the primary lesion and the mucocele the secondary lesion because osteoma can cause obstruction of sinus drainage leading to mucocele. Growth of mucocele in the paranasal sinus may be prevented by giant osteoma, resulting in intracranial extension of mucocele.…”

“…Only 21 cases have been reported previously. 1,3,[5][6][7][10][11][12][13][14][15][16][19][20][21][22] Paranasal sinus osteoma can protrude into the anterior cranial fossa and cause intracranial mucocele, as well as cerebrospinal fluid (CSF) leakage and pneumocephalus. 6,7,19,20) We describe a rare case of a giant intracranial mucocele associated with a paranasal sinus osteoma in a patient who presented with a generalized convulsion, discuss a hypothesis for the pathogenesis of the association, and the appropriate surgical strategy for co-existing lesions.…”