A Case Report of an Immediate Frontal Sinus Reconstruction Using an Outer Table Calvarial Bone Graft in an En Bloc Manner

전두동 골절 환자에서 머리덮개뼈의 바깥판을 한판으로 이용한 즉시 전두동 재건술 1례

  • Kim, Jong Do (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Kim, Jeong Tae (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University) ;
  • Kim, Youn Hwan (Department of Plastic and Reconstructive Surgery, College of Medicine, Hanyang University)
  • 김종도 (한양대학교 의과대학 성형외과학교실) ;
  • 김정태 (한양대학교 의과대학 성형외과학교실) ;
  • 김연환 (한양대학교 의과대학 성형외과학교실)
  • Received : 2011.02.07
  • Accepted : 2011.03.15
  • Published : 2011.04.10

Abstract

Background: In a frontal sinus reconstruction, the literature primarily recommends a surgical approach for definite treatment with the exception of for anterior wall fractures with no dislocation. Many studies have assessed a range of methods for the reduction of frontal sinus fractures. This paper presents a case, in whom the anterior wall of the frontal sinus was reconstructed using an outer table calvarial bone graft in an en bloc manner. Patient and methods: A 36-year-old male visited the emergency room with a heavy injury to the forehead. He was diagnosed with fractures of the anterior and posterior wall of the frontal sinus. The neurosurgeon removed the fractured area and repaired the meninges. Afterwards, cranialization was performed and the opening of the nasofrontal duct was obstructed. After fixing the removed bone to its original location, all fragments of fractured anterior wall were purged out and the anterior wall reconstructed using an en bloc calvarial bone graft. Results: In the post-operative 8 months period, there were no complications, the round contour of the forehead was expressed well and the patient was satisfied with the result. Conclusion: There are many methods for reconstructing the anterior wall of the frontal sinus. On the other hand, in cases of large fracture sites with many fractured bone fragments, en bloc harvesting of the outer table calvarial bone could be a better choice than making use of only plates and screws because this method shows a good results in terms of aesthetics with a low complication rate.

Keywords

References

  1. Moon SH, Oh DY, Seo BC, Rhie JW, Ahn ST: Small incision and dual-top screws for treatment of simple depressed anterior frontal sinus fracture. J Korean Soc Plast Reconstr Surg 35: 345, 2008
  2. Kwon JH, Hong SM, Han CY, Bahn JM, Kim GC, Park GH, Cho JH: Clinical study of frontal sinus fractures: A review of 14 cases. Korean J Otolaryngol-Head Neck Surg 41: 600, 1998
  3. Donald PJ: Frontal sinus fractures. In Donald PJ, Gluckman JL, Rice DH: The Sinuses. New York, Raven Press, 1995, p 369
  4. Jin HR, Shin SO, Choi YS, Song CK, Yong MG: Management of Frontal Sinus Fracture according to the type and severity of the fracture: Analysis of 23 cases. Korean J Otolaryngol-Head Neck Surg 43: 396, 2000
  5. Ioannides C, Freihofer HP, Vrieus J: Fracture of the frontal sinus: a rationale of treatment. Br J Plast Surg 46: 208, 1993 https://doi.org/10.1016/0007-1226(93)90170-G
  6. Alpert B, Seligson D: Removal of asymptomatic bone plates used for orthognathic surgery and facial fractures. J Oral Maxillofac Surg 54: 618, 1996 https://doi.org/10.1016/S0278-2391(96)90645-X
  7. Jeong JC, Choi SH, Song MS, Jun SH, Kim HM: Clinical study of resorbable plate and screw for treatment of maxillofacial fractures. J Korean Assoc Oral Maxillofac Surg 29: 438, 2003