Sinuses are mucosa-lined airspaces within the. In obturation, the posterior table must be preserved or restored. Both cranialization and obturation require the complete removal of sinus mucosa and closure of the cephalic part of the frontonasal duct with two key differences. The patient's recovery was uneventful.Įndoscopy employed in frontal sinus obliteration appears to be instrumental in obtaining meticulous mucosa removal, obviating the need for additional osteotomy of the frontal bone. The frontal sinuses are one of the four pairs of paranasal sinuses that are situated behind the brow ridges. Frontal sinus obliteration is performed for a variety of reasons, including chronic sinus disease, traumatic injuries, mucoceles, and osteomas of the sinus. Obturation is defined as filling of the frontal sinus with grafts, often consisting of adipose tissue.
and possible sinus obliteration to assure fracture reduction, fixation. The fracture by itself offered an “access port” for the endoscope and electrical cautery. Frontal sinus fractures contribute to 5-15 of all facial fractures and are most. To avoid additional osteotomy, endoscopic approach was undertaken to achieve the complete removal of the sinus mucosa. Due to the extent of the injury he underwent frontal sinus obliteration procedure using the pericranial flap. The authors’ patient suffered from comminuted fractures of the anterior and posterior tables of the frontal sinus and nasal bone fractures with involvement of the frontonasal ducts. Therefore, it may be also considered an adjunct in open-approach management of severely comminuted fractures. This involves exposure of the entire sinus, fastidious removal of all sinus mucosa and. Endoscopy, offering magnified visualization and less invasive access, is reported to be beneficial in sinus injury management. In this situation, frontal sinus obliteration may be required. This in turn increases fracture comminution requiring placement of additional hardware associated with the risk for bony malalignment, infection, plate palpability, and visibility, especially in thin-skin individuals. PATIENTS AND METHODS: This study was carried out on 20 patients having anterior table fracture of their frontal sinuses indicated for sinus obliteration. To achieve adequate access to the mucosa, temporary removal of a large part of the frontal bone may often be necessary. In a cranialization procedure, the posterior wall of the frontal sinus is removed and the sinus cavity is excluded from the cranial compartment by a pericranial graft.
This technique entails precise mucosa removal which requires unimpeded visualization of the bony recesses. The frontal sinus is filled and closed off in an obliteration procedure. Comminuted fractures of the anterior table of the frontal sinus involving frontonasal ducts are traditionally treated with sinus obliteration. Osteoplastic frontal sinusotomy with obliteration was popularized by Goodale and Montgomery in the 1950s and has been considered the gold standard procedure.