There are two hypotheses for this recurrence in the left ethmoid and frontal sinuses
In our first case, it was the MRI that clearly showed the site of communication of the abscess with the frontal sinuses
It appeared to have arisen from the left middle turbinate, and it extended laterally into the maxillary sinus, posteriorly into the anterior ethmoid cells, and superiorly into both frontal recesses and frontal sinuses.
The floor of both frontal sinuses was then removed in the usual manner for a modified Lothrop approach.
The tumor in our patient was extensive and involved both frontal sinuses.
The frontal sinus is the most technically challenging sinus to access, even more so when the surgeon is faced with a diffuse tumor involving both frontal sinuses.
Unlike the typical scenario in which the surgeon sees both frontal recesses and simply joins the floor of both frontal sinuses by dissecting medially, the margins of dissection are filled with tumor and there is no obvious cavity.
Congenital diseases that are characterized by a thin frontal bone cortex--such as McCune-Albright syndrome (5) and osteogenesis imperfecta (6)--can lead to dilation of the frontal sinuses
Among the 26 cases, the maxillary sinuses were involved in 15 cases, the sphenoid sinuses in 14, the ethmoid sinuses in 9, the frontal sinuses
in 2, and the nasal cavity only in 1.
The patient presented no evidence of sinusitis, cyst, or mucocele involving the frontal sinuses
Mucocele formation with intracranial or orbital extension is not an uncommon complication of sinus obstruction; this occurs more often in the sphenoid and frontal sinuses
and is best assessed by MRI.
Mucoceles are slowly growing but expansive lesions that usually originate in the frontal sinuses