Abstract
OBJECTIVE: To demonstrate the effectiveness of the endonasal endoscopic approach in managing a large bilateral frontal mucopyocele causing a mass effect on the brain. CASE PRESENTATION: A 17 year old chronic sinusitis patient, presented with bilateral nasal obstruction and increasing left sided headache; was found to have a very large bilateral frontal mucopyoceles with extensive intracranial extradural brain involvement on CT scan and MRI of the sinuses and brain which was drained and evacuated completely using the endonasal endoscopic image guided approach with no complications. CONCLUSION: The endonasal endoscopic image guided approach is the approach of choice in managing large frontal mucopyocele with brain extension. It is a safe, accurate, reliable approach with no complications.