Mucocoeles of the paranasal sinuses are relatively uncommon and in the
past have been generally treated by an external surgical approach. Fo
rty-eight mucocoeles in the frontal, fronto-ethmoidal and sphenoidal s
inuses have been treated during the last five years, 20 by an entirely
endonasal endoscopic approach and 28 by a combination of an external
procedure and an endoscopic approach. There were no recurrences in the
endoscopic group, with a mean follow-up of 34 months whilst three rec
urrences occurred in the combined external and endoscopic group which
had a mean follow-up of 44 months. This may reflect the complexity and
severity of concomitant disease. If a wide marsupialization can be ac
hieved by an entirely endoscopic approach there are a number of advant
ages, notably a lack of facial scarring in children and young adults.