Frontal Sinus Obliteration with the Pericranial Flap

Abstract

The pericranial flap is a vascularized local flap that is easily harvested. The use of the pericranial flap avoids donor site morbidity associated with free fat or cancellous bone grafts. The pericranial flap arms the head and neck surgeon with an effective alternative to other methods of frontal sinus obliteration.

Definitive Treatment of Persistent Frontal Sinus Infections: Elimination of Dead Space and Sinonasal Communication

“…Improper partitioning of the upper aerodigestive system from the anterior cranial base and proliferation of unextirpated sinus mucosa provide an environment for indolent pathogenesis. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] Inadequate frontal sinus fracture management leads to severe and potentially fatal complications. Surgical intervention is almost always required to correct the complex bone and soft-tissue deformities and eradicate infectious material from the frontobasilar region.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] Fat, muscle, bone, local flaps, and sundry alloplasts have been used as obliterative materials, with autologous tissues preferred over alloplasts, and cancellous bone and local flaps preferred over abdominal fat. 6,7,10,12,13,[15][16][17][18][19][20][21][22][23][24][25][26] Complications of a failed obliterated sinus result from inadequate removal of the frontal sinus mucosa and improper partitioning of the upper aerodigestive system from the anterior cranial base.…”

Utility of the pericranial flap in frontal sinus and anterior cranial fossa trauma

“…They can also increase morbidity after surgery through possible donor site complications and increased risk of infection associated with the use of a non-vascular graft 14 . The use of abdominal fat grafts has been extensively reported in the literature.…”

Post-trauma mucocele formation in the frontal sinus; a rationale of follow-up

“…The naso-frontal duct is obliterated using autologous bone, and periosteum. There is no consensus in the literature what material should be used for the obliteration of the sinus, bone, fat or muscle 2,4,8,9,17,20 ?…”

“…There is no consensus in the literature whether or not to fill the residual space. And if so what material should be used, bone, fat or muscle 2,4,8,9,17,20 ?…”