A practical and economical method for frontal sinus reconstruction after frontal craniotomy: A single-center experience with 140 patients

Abstract

BackgroundFrontal sinus exposure is a common consequence of frontal craniotomy. Cerebrospinal fluid leakage and infection are the major postoperative complications that may occur as a result of the open frontal sinus. The successful filling of the open frontal sinus provides an approach to prevent significant complications caused by frontal sinus exposure.ObjectiveThis article describes a new technique to reconstruct the exposed frontal sinus cavity with the combined application of gelatin sponge and a vascularized pericranial flap.MethodsA total of 140 patients underwent frontal sinus reconstruction using gelfoam and vascularized pericranial flaps from 2016 to 2021. Gelatin sponge was used to fill the frontal sinus, and a vascularized pericranial flap was used to cover the frontal sinus when the bone flap was retracted.ResultsPostoperative cerebrospinal fluid leakage and infection did not occur in any patient.ConclusionOur results validated the effectiveness of our technique in the prevention of exposed frontal sinus-related postoperative complications.

The Usefulness of Surgical Titanium Microclips for Mucosal Repair in the Frontal Sinus Using ORBEYE: A Technical Note

“…13) Various methods of repairing the frontal sinus using fat, muscle fragments, periosteum, polymethyl methacrylate, fibrin glue, section from the bone flap, and artificial bone have also been reported. While many reports discuss the frontal sinus closure, [3][4][5][6][7][8][9][10] only one report has demonstrated a method of mucosal repair. 4) In the report, the mucosa was detached from the frontal sinus and sutured using 7-0 nylon.…”

“…2) Therefore, if the frontal sinus is opened, repairing the frontal sinus mucosa and closing the frontal sinus are crucial. Opening the frontal sinus may be accompanied by mucosal injury; however, although several reports have described how to close a frontal sinus, [3][4][5][6][7][8][9][10] few studies have described how to reconstruct the mucosa. Typically, damaged mucosa is repaired by handsewn suturing; 3) however, this may require working space and time.…”

Management of Giant Frontoethmoid Osteoma by Combined Approach

“…Additionally, patients may experience skin texture changes, such as scars or dimples on the forehead, as a late complication due to the formation of adhesions between the skin-soft tissue layer and underlying hardware and these can be avoided by using pericranial flap in combined or external approach for management of frontal osteomas [14]. The use of pericranial flaps has been widely employed for the management of anterior skull base tumours and fractures [15,16], and in the management of frontal osteoma [13]. Its utilization can provide multiple benefits, including sinus obliteration and the safeguarding of hardware used in the reconstruction of the anterior wall of the frontal sinus, thus reducing the risk of postoperative complications and the need for additional surgery [13,14].…”