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This involves exposure of the entire sinus, meticulous removal of all sinus mucosa, and removal of the posterior table bone (4) create a secure barrier between the nose/nasofrontal duct and the frontal sinus/neoanterior cranial. The anterior table bone is replaced to reconstitute the forehead contour.
Cranialization refers to the removal of the posterior table of the frontal sinus with occlusion of the inlet into the frontonasal ducts and allowing the neural structures, mainly frontal lobes of the brain and the intact dura, to move directly posterior to the anterior table of the frontal bone. (3) remove completely all frontal sinus mucosa Cranialization is best suited for severe frontal sinus injuries, with comminution of the posterior table bone
The procedure is typically carried out by a multidisciplinary team, including an otolaryngologist and a neurosurgeon.
Compartmentalization is an open technique for repair of the frontal sinus using allograft onlay and a vascularized periosteal flap that allows for preservation of frontal sinus function. Obliteration of the frontonasal duct is essential when duct patency cannot be preserved during cranialization This technical note presents a minimally invasive method using the buccal fat pad harvested through the temporal extension via a standard coronal approach. The frontal sinus can be divided in three surgical anatomic regions
The frontal sinus cavity, the frontal sinus ostium, and the frontal sinus recess Frontal sinus cranialization will address the first two anatomic regions. Surgical confidence requires a comfort level with angled endoscopes (45 and 70 degrees) and dedicated frontal sinus instrumentation as well as the ability to translate the patient's frontal recess ct findings into a surgical plan by studying all three planes of the ct scan. These patients were diagnosed with frontal sinus lesions and surgically managed by cranialization of the frontal sinus using pericranial flaps to separate the intracranial cavity from endonasal sinuses.
(2) remove all bone of the posterior table
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