DOI: https://doi.org/10.36347/sjmcr.2026.v14i05.003

Pages: 872-877

Paranasal sinus mucoceles are epithelium-lined cystic lesions caused by obstruction of sinus drainage; they may progressively expand with bony remodeling or erosion and can lead to orbital or intracranial complications (Capra et al., 2012; Scangas et al., 2013; Lund & Milroy, 1991). We report two frontal sinus mucoceles treated surgically in our department in 2022 and provide a narrative review focused on surgical route selection and complication prevention. Both patients presented with a cosmetically deforming supraorbital swelling (with mild exophthalmos in one case); likely etiologies were chronic rhinosinusitis with nasal polyps/aspirin-exacerbated respiratory disease and remote facial trauma. A combined strategy (limited eyebrow incision for direct evacuation plus endonasal frontal sinusotomy (Draf II) to establish durable drainage, with temporary catheter placement) resulted in rapid clinical improvement, with no clinical recurrence after 15–18 months of follow-up. Endoscopic marsupialization remains the standard of care for most mucoceles; however, in selected frontal mucoceles with marked anterior table bulging/erosion, lateral/supraorbital extension, or difficult endonasal access, a combined approach can help secure drainage while preserving cosmesis.