ASPECTS OF FRONTAL-SINUS SURGERY .3. INDI CATIONS AND RESULTS OF OSTEOPLASTIC FRONTAL-SINUS SURGERY

The osteoplastic approach is indicated for frontal sinus surgery if op timal exposure of the entire frontal sinus is required for possibly co mplete removal of the mucous membrane and sinus obliteration. In a ret rospective study we evaluated 75 patients whose osteoplastic frontal s inus operations were performed in Fulda between 1979 and 1992 and exam ined indications for surgery, complications and outcome. All patients were examined clinically and subjective complaints were recorded. Indi cations for surgery were trauma (43), acute and chronic infections (19 ), tumors (11) and sinus pneumatoceles (2). The overall aesthetic and functional outcome was excellent. Revision was necessary in one only p atient, who had forced air into his frontal sinus by nose-blowing too early to create a threat of infection. No serious complications occurr ed, such as surgery-related meningeal injury or impaired or double vis ion. One patient needed a blood transfusion because of hemorrhage due to operation (1.3%). The main advantage of the coronal incision used w as preservation of the supraorbital nerve bundle without subsequent ne rve dysfunctions. Besides optimal exposure of the whole frontal sinus, precise replacement of the osteoplastic flap and choice of incision a lso lead to a good aesthetic result.