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A frontal mucocele is a paranasal sinus mucocele in a frontal sinus and is the most common location of all the paranasal sinus mucoceles 1.
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Mucocoeles in the frontal sinus may be asymptomatic with insidious onset or present with headaches 2 and facial pain. Forehead (supraorbital) swelling and orbital cellulitis 3 may also be present.
If there is orbital cavity invasion, patients may have proptosis, hypotropia, and diplopia.
- homogeneously hypodense, expansile lesion within an airless frontal sinus 4
- does not enhance with contrast
- may demonstrate remodeling, thinning, or erosion of the sinus walls
- used for surgical planning
- useful for defining intracranial extension or obstructing malignancy 1
- contents of the mucocele produce different signal intensities depending on the amount of desiccated 4
- water-rich content: low signal (most common)
- protein-rich content: high signal
- water-rich content: high signal (most common)
- protein-rich content: low signal
- may look like an air-filled sinus in advanced disease
- T1 C+ (Gd): enhancement, if present, only occurs at the periphery
- DWI/ADC: variable
Possible considerations include:
allergic fungal sinusitis
- no bony expansion
mucus retention cyst
- does not completely fill the sinus
- no bony expansion
- sinonasal polyposis
- fibrous dysplasia 5
- 1. Harnsberger HR, Osborn A, Macdonald A, Ross J. Diagnostic and Surgical Imaging Anatomy - Brain, Head & Neck, Spine. Amirsys; 2006.
- 2. Scangas GA, Gudis DA, Kennedy DW. The natural history and clinical characteristics of paranasal sinus mucoceles: a clinical review. (2013) International forum of allergy & rhinology. 3 (9): 712-7. doi:10.1002/alr.21178 - Pubmed
- 3. Herndon M, McMains KC, Kountakis SE. Presentation and management of extensive fronto-orbital-ethmoid mucoceles. (2007) American journal of otolaryngology. 28 (3): 145-7. doi:10.1016/j.amjoto.2006.07.010 - Pubmed
- 4. Mandell J. Core Radiology: A Visual Approach to Diagnostic Imaging. Cambridge University Press; 2013.
- 5. Suri A, Mahapatra AK, Gaikwad S, Sarkar C. Giant mucoceles of the frontal sinus: a series and review. (2004) Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 11 (2): 214-8. doi:10.1016/j.jocn.2003.02.011 - Pubmed