Endoscopic and external surgical approach to paranasal sinus mucocele

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Mucoceles of the paranasal sinuses are not common, but usually present as cystic lesions causing facial asymmetry requiring surgery. Hitherto surgical attempts at excision were external surgical approaches with the use of stents to drain the frontoethmoidal sinus, if they were the principal sinus involved, for a variable period. Recent advances in endoscopic sinus surgery have made the endoscopic approach to surgically manage paranasal sinus mucoceles the new trend. A total of 18 patients were seen over a ten-year period with paranasal sinus mucocele; 14 cases were managed through the external approach, while four were consecutively managed endoscopically. The endoscopic approach in the surgical management of mucoceles of the paranasal sinuses and the external approach are discussed in this article with the intent of showing the advantages of the two approaches, with more emphasis on the endoscopic approach and caution that should the endoscopic approach prove difficult, reversal to the external approach should be undertaken immediately, so as to avoid unnecessary complications.