Extensive sphenoethmoid mucocele - An endoscopic management

Sphenoethmoidal mucoceles are rare tumors. They gradually expand in size and rarely produce bony destruction of sinus walls, leading to orbital, ocular, and intracranial involvement. We present a rare case of sphenoethmoidal mucocele with bone destruction and intracranial extension, who presented with nasal blockade and loss of visual acuity. Computed tomographic scan revealed a soft tissue mass, eroding the base of anterior cranial fossa, extending intracranially into the parasellar temporal fossa. The patient was treated successfully by endoscopic excision. Although a transfacial approach is generally preferred in cases of extensive mucoceles with intracranial extensions, a thorough anatomy of the nasal skull base and proficient use of the endoscope can be a good alternative to such lesions.