The authors present a patient casewith giant frontal sinus mucocele with intracranial spread after numerous operations for nasal polyposis. Patient suffered no symptoms since last operation 7 years ago. A 2-month progressive bony prominence above upper eyelid and decreased nasal patency appeared to be nasal polyposis and frontal sinus mucocele eroding posterior and inferior sinus wall according to anemnesis and further clinical investigation. The intracranial growth manifested no neurological deficit. The expansive process caused laterocaudal eyeball dislocation. The mucocele was resected and giant nasal polyps were extracted from Raven’s subfrontal approach in cooperation with neurosurgeon. The postoperative course was uneventful. The cosmetic result 3-month after surgery was more than satisfactory. A follow-up MRI and endoscopy of nasal cavity revealed no sign of recurrence. In conclusion authors stress advantages of Raven’s approach. Furthermore, indication criteria for different surgical approaches in frontal sinus mucocele treatment are discussed.

        Key words: mucocele, frontal sinus, aggressive growth, complications of nasal polyposis, Raven’s subfrontal approach.