A CASE OF FRONTAL SINUS CYST FOR TREATING WHICH THE TRANSCRANIAL APPROACH WAS USEFUL

• Published in: JIBI INKOKA TEMBO Vol. 63; no. 1; pp. 23 - 29
• Main Authors: Ishii, Kenta, Tsunemi, Yasuhiro, Akutsu, Makoto, Kashiwagi, Takashi, Konno, Wataru, Goto, Kazutaka, Nakajima, Itsuo, Hirabayashi, Hideki, Haruna, Shinichi
• Format: Journal Article
• Language: Japanese
• Published: Society of Oto-rhino-laryngology Tokyo 15.02.2020
• Subjects: periorbital lesion; transcranial approach; transnasal approach; transorbital approach
• ISSN: 0386-9687; 1883-6429
• DOI: 10.11453/orltokyo.63.1_23

We report a case of frontal sinus cyst extending to the right orbit. It was extremely difficult to remove the cyst via only the transnasal approach, because of a calcified lesion in the frontal fossa.　The patient, 29-year-old woman, presented to our ophthalmology department with right eyelid swelling. Right eye protrusion was observed, however, there was no evidence of eyesight deterioration or eye movement disorder. She was referred to our department for further examination and treatment, because CT revealed a cyst-like lesion in the right orbit and frontal sinus.　A calcified lesion was seen in the right frontal fossa, and a 3-cm cyst-like lesion was found in the superior intraorbital wall, and the lesion was found to extend into the frontal sinus.　With the neurosurgeons' assistance, the frontal skin was lifted by a coronary incision. Thereafter, the lumen of the frontal sinus was confirmed by fenestrating the frontal bone.　As a result, the lesion was found to be a frontal sinus cyst. We thought that it was a good indication for extranasal surgery, because the lesion was present outside the nasal cavity and the calcification was found in the frontal fossa. In this report, we mainly consider the operation methods for periorbital lesions.