DEVELOPMENT OF THE FRONTAL-SINUS FOLLOWING BILATERAL FRONTO-ORBITAL OSTEOTOMIES

The presence of frontal sinuses following bilateral fronto-orbital adv ancement is discussed controversially in the literature. In a retrospe ctive study, 33 patients (18 male and 15 female) were operated on betw een 1982 and 1993, with at least one year postoperative follow-up and with a minimum age of 6 years at the end of the,follow-up period follo wing bilateral fronto-orbital remodelling, were included. The average age at which the procedure was performed was 29 months with a minimum of 3 months and a maximum of 7.8 years. The study presented shows a pn eumatization of the frontal sinus in 72.7% of 33 patients following bi lateral fronto-orbital advancement. The first radiographic signs of si nus development were detected between the ages of 4 and 11, average 8. 3 years. There were no statistically proven correlations between front al sinus pneumatization and age at operation or the amount of advancem ent or sex of the patients. Surgical enlargement of the cranium by fro ntal advancement with adequate stabilization results in an enlargement of the neurocranium, thereby decreasing pressure on the inner frontal cortex and allowing frontal sinus pneumatization to proceed normally. Hence, the development of a frontal sinus may be a reflection of the effectiveness of the surgical therapy.