MUCOCELES OF THE PARANASAL SINUSES WITH INTRACRANIAL AND INTRAORBITALEXTENSION - REPORT OF 28 CASES

TWENTY-EIGHT PATIENTS RECEIVED surgical treatment for a paranasal sinu s mucocele with intracranial and/or intraorbital extension. The lesion s were classified by site and extension: anterior without intracranial extension (Type 1), 7 patients; anterior with intracranial extension (Type 2), 11 patients; posterior midline without intracranial extensio n (Type 3), 5 patients; and posterior with intracranial extension (Typ e 4), 5 patients. The surgical approaches were: transnaso-orbital, tra nsfrontonaso-orbital, transsphenoidal, transmaxillosphenoidal, and sub frontal transbasal; the choice depended on the site and extension of t he lesion, with the aim of securing maximum exposure to ensure total r emoval of the lesion with its capsule. A transcranial approach was res erved for mucoceles possessing an intracranial extension or causing di stension of the bone structures with optic pathway neurological sympto ms. With a coronal or transfacial skin incision along the lines of the forehead, nose, and orbital muscles of expression and careful reconst ruction, the patients' natural cast of features was spared or restored in