An Effective Method of Frontal Sinus Reconstruction After Bifrontal Craniotomy: Experience with 103 Patients

Takeuchi, Satoru; Tanikawa, Rokuya; Katsuno, Makoto; Tsuboi, Toshiyuki; Noda, Kosumo; Oda, Jun; Maeda, Shiro; Kamiyama, Hiroyasu

doi:10.1016/j.wneu.2015.01.030

Cited by 17 publications

(19 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Murai et al 11 reported mucosal suturing with a boney cap in 51 patients. Takeuchi et al 12 reported mucosal suturing with abdominal fat packing in 103 patients. None of the patients in either study developed postsurgical CSF leakage.…”

Section: Discussionmentioning

confidence: 99%

Anatomy of the Frontal Sinus Drainage Pathway Evaluated in 247 Cadavers to Prevent Cerebrospinal Fluid Leakage After Frontobasal Craniotomy

Kodera,

Isozaki,

Akazawa

et al. 2023

Operative Neurosurgery

View full text Add to dashboard Cite

BACKGROUND AND OBJECTIVES: The frontal sinus (FS) drainage pathway (FSDP) may be a conduit for cerebrospinal fluid leakage after frontobasal craniotomy. In this cadaveric study, we aimed to evaluate the anatomy of the FSDP. METHODS: The FSs and FSDPs of 247 cadavers were investigated. We counted the number of FSs and FSDPs in each half-head, verified the presence of a narrowing section in each FSDP, and evaluated the depth, shape, and size of each narrowing FSDP section. RESULTS: We investigated 494 sides and 472 FSDPs of 247 cadavers. FSs were unilaterally undeveloped in 13 of 247 cadavers (5.3%) and bilaterally in 8 (3.2%). FSs were unilaterally duplicated in 7 of 247 cadavers (2.8%), and no FSs were bilaterally duplicated or triplicated. No FSs had 2 or more FSDPs, and all 472 investigated FSDPs were invariably narrowed at various depths. The narrowing FSDP sections were elliptical (78.6%), circular (18.1%), triangular (1.8%), or crescent-shaped (1.4%) and of varying thickness and orientation. Although FSDPs were asymmetric in 92.2% of cadavers and narrowing FSDP sections were located deep (8.9 ± 4.4 mm from the anterior skull base), the narrowing FSDP sections were typically small (area: 5.9 ± 3.3 mm2) or thin (short diameter: 2.1 ± 0.7 mm). CONCLUSION: Each FS had only one FSDP, all FSDPs were invariably narrowed at various depths, and the narrowing FSDP sections were sufficiently small or thin to allow local closure, facilitating prevention of cerebrospinal fluid leakage after frontobasal craniotomy.

show abstract

Section: Discussionmentioning

confidence: 99%

Anatomy of the Frontal Sinus Drainage Pathway Evaluated in 247 Cadavers to Prevent Cerebrospinal Fluid Leakage After Frontobasal Craniotomy

Kodera,

Isozaki,

Akazawa

et al. 2023

Operative Neurosurgery

View full text Add to dashboard Cite

show abstract

“…Fat has a wide range of sources and strong plastic characteristics, which makes it widely used in the frontal sinus obliteration. However, the use of fat could cause additional damage to the donor sites and prolonge the operative time ( 11 , 17 , 18 , 23 ). The pericranial flap is commonly used for anterior skull base reconstruction ( 24 – 26 ).…”

Section: Discussionmentioning

confidence: 99%

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

Guo

Yin

et al. 2022

Front. Surg.

View full text Add to dashboard Cite

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.

show abstract

“…The rate of bone-flap infection in all types of craniotomies varies from 1–11% depending on factors such as the type of surgery, duration of surgery greater than 4 h, occurrence of CSF leak, and prior radiation treatments [ 5 , 6 , 9 ]. The reported rate of infection for bifrontal craniotomies with or without skull base osteotomies is between 1–7%, which is higher than that of all other craniotomy types [ 2 , 10 , 11 , 12 ]. Roughly half of these infections correspond to bone-flap osteomyelitis.…”

Section: Discussionmentioning

confidence: 99%

Bifrontal Osteoplastic Flap: An Option to Decrease Infection in Bifrontal Craniotomies with Skull Base Osteotomies

et al. 2022

View full text Add to dashboard Cite

Infection can be a common complication following bifrontal craniotomy with skull base osteotomies given the potential violation of sinuses and entry into the nasal structures. Our objective was to examine our series of patients who underwent a bifrontal craniotomy with skull base osteotomies and describe the infection rate. We propose the bifrontal osteoplastic flap as an adjunct to infection prevention. A retrospective single-center study of a patient database was performed. Twenty patients were identified. Fifty-five percent were male. The mean age was 55.7 ± 13.9 years. The most common indications for surgery were esthesioneuroblastomas (35%) and anterior skull base meningiomas (30%). Six patients (30%) developed an infection, 1 patient (5%) developed a CSF leak, and no patients developed a mucocele. All 6 infected cases had nasal pathology with intracranial extension, they all received chemoradiation post-operatively and were all combined cases with otorhinolaryngology. Eighty-three percent of these patients required a craniectomy and all of them required long-term IV antibiotics. Infection is not uncommon after a bifrontal craniotomy with skull base osteotomies and the use of the bifrontal osteoplastic flap in cases where the risk of infection is high, i.e., esthesioneuroblastomas surgery, may help reduce said risk and lead to better patient outcomes.

show abstract

An Effective Method of Frontal Sinus Reconstruction After Bifrontal Craniotomy: Experience with 103 Patients

Cited by 17 publications

References 30 publications

Anatomy of the Frontal Sinus Drainage Pathway Evaluated in 247 Cadavers to Prevent Cerebrospinal Fluid Leakage After Frontobasal Craniotomy

Anatomy of the Frontal Sinus Drainage Pathway Evaluated in 247 Cadavers to Prevent Cerebrospinal Fluid Leakage After Frontobasal Craniotomy

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

Bifrontal Osteoplastic Flap: An Option to Decrease Infection in Bifrontal Craniotomies with Skull Base Osteotomies

Contact Info

Product

Resources

About