Frontal Paranasal Sinus Mucocoele


If it feels like your sinuses are blocked, it may be due to the buildup of mucus in one or more of the paranasal sinus cavities.

This usually occurs because of an obstruction that affects nasal sinus drainage. The sinuses most often affected – more than 50 percent of the time – by this type of blockage and mucus buildup are the frontal paranasal sinuses, which are located above the eyes behind the brow ridges.

Causes and Symptoms

Sinus mucocoeles are typically related to a nasal obstruction that develops due to some type of trauma, the presence of nasal polyps or similar lesion, or inflammation. Over time, the frontal paranasal sinuses may expand as mucus accumulates. Sinus mucocoeles have also been linked to fluid-filled cysts that gradually enlarge and chronic non-invasive fungal sinusitis.

Children with cystic fibrosis are more likely to have sinus problems of this nature. Most mucocoeles develop with clear, thick mucus, although the mucus may be cloudy if an infection develops. Symptoms associated with frontal sinus mucocoeles include:

  • Sinus drainage
  • A persistent “stuffed up” feeling
  • Eye and/or cheek swelling
  • Pressure in the lower forehead
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How a Diagnosis is Made

Because of the location of the frontal paranasal sinuses, the most effective way to identify mucocoeles is with either a CT scan or MRI. A skull radiograph is sometimes done if there is a need to determine if the affected sinus passage has expanded significantly.

CT and MRI scans are useful because they show bony defects and areas where there has been an expansion of the blockage. Images test can also identify other possible reasons for mucus buildup that may include:

  • Paranasal sinus tumors
  • Mucus retention cysts
  • Antrochoanal polyps (ACP) – abnormal growths related to mucus buildup

A nasal endoscopy may be done as well for diagnostic purposes to determine if other sinus passages are affected. You may also be asked about your history with sinus infections or irritations and whether or not you have underlying issues or sinus defects that could be contributing to mucus buildup.

Treating Frontal Paranasal Sinus Mucocoeles

Frontal paranasal sinus mucocoeles may first be treated with nasal irrigation methods. However, the most effective treatment method is usually endoscopic surgery. This process involves inserting a lighted scope with an attached lens via the nostrils to reach the affected sinus cavity. Special instruments are used to remove polyps, cysts, or tumors if any of these abnormalities are present.

Reconstructive surgery is sometimes needed if large, bony defects are discovered when image tests are performed. The approach to reconstructive surgery that’s recommended at UCI’s Sinus Surgery Center will depend on the extent of the bony defects. If possible, the preferred option is endoscopic surgery since minimally invasive techniques that reduce risks for the patient are used.

There are no standard recommendations for preventing frontal paranasal sinus mucocoeles. As with similar sinus-related problems, however, you may be able to reduce your risk of developing a blockage by avoiding nasal or sinus irritants as much as possible. It can also be helpful to develop a more effective treatment or symptom management plan if you have recurring sinus infections or issues with allergies.