Cranialization of the frontal sinus: indications, technique and results

The osteoplastic frontal sinus surgery with obliteration of the sinus has b een established in the therapy of frontal sinus diseases that can not be dr ainaged permanently or healed through an endonasal access. The obliteration of the frontal sinus is endangered in cases of multiple fracturing of the posterior frontal sinus wall or if it has been destroyed by an inflammatory process. In these problematic cases obliteration bears the danger of compl ications and cranialization of the frontal sinus is therefore the method of choice. We review 8 patients who were operated on using the cranialization technique. Indications for surgery were a combined fracture of the anterio r and posterior frontal sinus wall (3), a pyocele of the frontal sinus with extensive destruction of the posterior wall (4) and a large osteoma of the posterior frontal sinus wall (1). The frontal sin us was exposed through a coronal incision,the mucosa and the posterior wall were completely removed and the frontal sinus obliterated with fat tissue. The anterior sinus wall was replaced after obliteration of the sinus or reconstructed with calvari an bone transplants. The follow up period was 1.8 years (11 months to 8 yea rs). All patients underwent postoperatively a clinical ENT-examination and radiological assessment by Ci-Scan or MRI. The overall functional and esthe tic outcome was excellent. There were no serious complications nor a ny rec urrence. The cranialization of the frontal sinus is a reliable and safe var iation of the classical osteoplastic frontal sinus surgery with fat obliter ation.