• Supraorbital ethmoid mucocele;
  • frontal sinus mucocele;
  • ethmoid mucocele;
  • endoscopic sinus surgery;
  • supraorbital ethmoid disease;
  • Lothrop procedure;
  • endoscopic modified Lothrop procedure;
  • hemi-Lothrop;
  • Draf III;
  • Draf IIB


The supraorbital ethmoid (SOE) cell is an accessory ethmoid cell in the frontal area that extends into and pneumatizes superolaterally along the orbital plate of the frontal bone. The outflow pathway of the SOE cell can become obstructed, leading to an SOE mucocele. Given their lateral location, SOE lesions are traditionally treated through external approaches, although some authors have advocated treatment through standard endoscopic routes. We present a case of a large, supraorbital ethmoid mucocele treated with a novel modified hemi-Lothrop procedure (MHLP). This technique provides the benefit of an angulated approach to increase lateral visualization and bimanual, binostril instrumentation through a superior septectomy window.