Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit
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08-DECEMBER-2010 ATTALLAH HASAN AL-SHBEKAT 54
YEARS INFECTED MASS IN THE FRONTAL SINUS WITH RIGHT INTRAORBITAL EXPANSION
is a doctor
came to the clinic 04-December-2010 complaining
of throbbing pain of the right eye for 10 days.
He had similar episode 5 years ago and was
treated for sinusitis.
MRI of the
brain performed 27-November-2010 showing
huge mass in the frontal sinus, filling the
right side and destroying the right orbital roof
and pushing the globe down and lateral. CT-scan
performed showing the bone defect between the
frontal sinus and the right orbit.
examination: The patient has right
ophtalmalgia with double vision and the
right eye is pushed down and lateral with oedema
of the eye lids, more the superior. There is
hypalgesia of the right supratrochlear nerve
territory. He has also hyposmia in the right.
Bifrontal skin incision was performed 3 cm
posterior to the hair line and reflected to the
Modified bifrontal craniotomy was done,
preserving the frontal sinus in the left and
violating the right part. The dura was severely
adherent to the bone that it was necessary to
separate it stepwise. The dural tears were
stitched. A huge amount of pus came out
and the mucocele was removed totally. The wall
of the mucocele was removed from the dura
through the bone defect in anterior fossa and
the wall also removed from the periorbita right
eye through the bone defect in the superior
orbital wall. The mucosa was removed entirely
from the sinus. The involved frontal sinus part
was a closed cavity and it had no communication
with other sinuual parts, for what a tunnel was
created to obtain passage to the nasal sinuses.
closure of the wound. Redy-Vac drain under the
skin. Smooth postoperative
The patient has persistent
mass in the frontal sinus right side and it
caused destruction of the bone between the
frontal sinus and the right orbit. Mucocele
could do that, but another benign tumors could
do that also.
The cause of such destruction
is the absence of communication between the
involved cavity and other sinuses. Creating such
communication is the important step to prevent
future recurrence of such mucocele.
Please! wait for 3-5 min till the
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Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .