Experiences with the Osteoplastic Anterior Wall Approach to the Frontal Sinus: Case Histories and Recommendations

Frontal sinus osteomyelitis with midline fistula

“…They took the osteoplastic fl ap procedure step further, describing methods of ablating the frontal sinus by grossly removing all sinus mucosa and packing it with autogenous fat, essentially eliminating the sinus as a functional unit [3,4,5].…”

“…The technique commonly employed these days is based upon the method described by Bergara and Itoiz osteoplastic fl ap procedure and Goodale and Montgomery ablative frontal sinus technique [4,5,6].…”

“…The principal disadvantage of gull-wing incision is the need to divide the supraorbital nerve, which result in troublesome paresthesia and numbness of the forehead postoperatively. The bicoronal incision offers better exposure of the frontal sinus and more easily permits the use of osteoplastic fl aps and grafting materials for sinus obliteration with the benefi t of completely hidden scar except in cases with male pattern baldness [4,5].…”

“…Alloplastic materials include Proplast, acrylic resin, Gelfoam, and methyl methacrylate. Overall, autogenous materials appear to be more successful than alloplastic materials in achieving obliteration and preventing long-term complications [4,5,6].…”

“…Third, occlusion of the nasofrontal duct except in cases with suspected CSF leak. Fourth, selection of appropriate ablative material [4,5,6].…”