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Journal of Neurological Surgery. Part... Oct 2016Much of craniofacial trauma involves the frontal sinuses. Because of its response to injury, the frontal sinus mucosa has an innate ability to develop mucoceles, and if... (Review)
Review
Much of craniofacial trauma involves the frontal sinuses. Because of its response to injury, the frontal sinus mucosa has an innate ability to develop mucoceles, and if infected, mucopyocoeles. This article presents a therapeutic algorithm for all forms of craniofacial trauma with concentration on the most severe injury-the through and through fracture and its surgical remediation.
PubMed: 27648398
DOI: 10.1055/s-0036-1584816 -
Head & Face Medicine Mar 2023The purpose of the present study was to determine the dimorphic potential of the frontal sinus (FS) index, area, and the combination of both variables to ascertain its...
BACKGROUND
The purpose of the present study was to determine the dimorphic potential of the frontal sinus (FS) index, area, and the combination of both variables to ascertain its accuracy in sex discrimination among Bosnian, Chinese, and Nepalese.
METHODS
A retrospective study analyzed the digital standardized lateral cephalometric of 654 Bosnian, Chinese, and Nepalese adult patients (116 females, 102 males; age range 17-40 years). The following FS parameters were analyzed: The maximum height, width, and area of the FS, and the ratio of height and width was calculated as the FS index. The measurements were analyzed using logistic regression analysis for the FS index, area, and combined FS index and area.
RESULTS
Statistically significant differences were observed between the mean values of the FS index and the area between females and males in each population. The highest frequency of bilateral absence of FS was detected among females, specifically in Chinese (6.6%). Logistic regression equation derived from the present study differentiated between sexes with higher classification percentages for the FS index and area with 62.4%, 75.2%, and 78.4% among Bosnian, Chinese, and Nepalese subjects, respectively.
CONCLUSIONS
The results of the present study highlight the implications of the combined FS index and area as a reliable approach in sex estimation in forensic science whenever both the FS structure and lateral cephalometric are available.
Topics: Adult; Male; Female; Humans; Adolescent; Young Adult; Frontal Sinus; Retrospective Studies; Cephalometry
PubMed: 36918984
DOI: 10.1186/s13005-023-00355-4 -
Indian Journal of Otolaryngology and... Apr 2023In order to perform a successful endoscopic frontal sinus surgery, prevent complications, and lower the recurrence risk, it is essential to understand the anatomy of the...
In order to perform a successful endoscopic frontal sinus surgery, prevent complications, and lower the recurrence risk, it is essential to understand the anatomy of the frontal sinus (FS) and frontal recess cells with many variations in frontal sinus drainage (FSD). Preoperative assessment of the FSD in three levels in order to find prognostic factors in the decision process regarding the kind and the extent of surgery when required. Three FSD levels were assessed by computed tomography in two dimensions; antero-posteriorly and laterally in 100 consecutive patients with chronic sinusitis symptoms. The first level represents the proper drainage of FS. The second level is the drainage of FS without the effect of the frontoethmoidal cells. The third level is the maximum drainage that can be achieved in a single FS. The relation of FSD levels to FS and frontoethmoidal cells pathology were assisted. Within 100 patients (200 sides, 186 FSs), for the proper FSD, antero-posterior (AP) length was 5.94 ± 3.42 mm in opaque FS and 5.32 ± 2.87 mm in clear FS and its lateral length was 3.04 ± 1.6 mm in opaque FS and 2.30 ± 1.25 mm in clear FS. For the functional FSD, AP length was 8.97 ± 2.7 mm in opaque FS and 8.05 ± 2.7 mm in clear FS and its lateral length was 7.51 ± 1.69 mm in opaque FS and 7.58 ± 1.75 mm in clear FS. In the anatomical FSD, AP length was 11.25 ± 3.07 mm in opaque FS and 10.01 ± 2.87 mm in clear FS and its lateral length was 11.1 ± 2.6 mm in opaque FS and 10.95 ± 1.7 mm in clear FS. This study offers essential data for preoperative assessment in order to improve surgeons' awareness of the frontoethmoidal region for optimal safe EFSS with lower incidence of complications and recurrences.
PubMed: 37206767
DOI: 10.1007/s12070-022-03230-x -
Ear, Nose, & Throat Journal Nov 2023The aim of this study was to report the surgical management experience of patients with osteomas of the frontal and ethmoid sinuses performed in 2 metropolitan Italian...
OBJECTIVES
The aim of this study was to report the surgical management experience of patients with osteomas of the frontal and ethmoid sinuses performed in 2 metropolitan Italian hospitals between 2012 and 2019.
METHODS
A retrospective chart review of cases of frontal and ethmoid osteomas from the of Milan and the of Rome was performed. All patients underwent preoperative computed tomography and, when orbital or intracranial extension was suspected, magnetic resonance imaging. Surgical treatment was performed according to Chiu classification.
RESULTS
A total of 38 cases of frontal and ethmoid sinus osteomas were included in the study; 22 patients were men and 16 were women. The mean age at diagnosis was 49 years. Seven (18.4%) patients were treated using an open approach; 3 (7.9%) patients underwent open and endoscopic approach; the remaining 28 (73.7%) patients were treated with endoscopic approach. Seven (18.4%) patients had a cerebrospinal fluid leak intraoperatively and were treated with the placement of tissue graft through the defect. The mean follow-up time was 18 months; no recurrence was observed at 12-month follow-up.
CONCLUSION
Osteomas of the frontal and ethmoid sinuses can be treated using different techniques, mostly endoscopically. The choice of surgical approach (endoscopic vs open) depends on the location and size of the osteoma, anatomical size, characteristic of the sinus, surgeon's experience, and available existing technical facilities. Cerebrospinal fluid leak is a possible complication of surgery.
Topics: Male; Humans; Female; Middle Aged; Ethmoid Sinus; Retrospective Studies; Paranasal Sinus Neoplasms; Treatment Outcome; Endoscopy; Osteoma; Hospitals; Cerebrospinal Fluid Leak; Frontal Sinus
PubMed: 34176317
DOI: 10.1177/01455613211016895 -
Frontiers in Surgery 2022Frontal sinus exposure is a common consequence of frontal craniotomy. Cerebrospinal fluid leakage and infection are the major postoperative complications that may occur...
BACKGROUND
Frontal sinus exposure is a common consequence of frontal craniotomy. Cerebrospinal fluid leakage and infection are the major postoperative complications that may occur as a result of the open frontal sinus. The successful filling of the open frontal sinus provides an approach to prevent significant complications caused by frontal sinus exposure.
OBJECTIVE
This article describes a new technique to reconstruct the exposed frontal sinus cavity with the combined application of gelatin sponge and a vascularized pericranial flap.
METHODS
A total of 140 patients underwent frontal sinus reconstruction using gelfoam and vascularized pericranial flaps from 2016 to 2021. Gelatin sponge was used to fill the frontal sinus, and a vascularized pericranial flap was used to cover the frontal sinus when the bone flap was retracted.
RESULTS
Postoperative cerebrospinal fluid leakage and infection did not occur in any patient.
CONCLUSION
Our results validated the effectiveness of our technique in the prevention of exposed frontal sinus-related postoperative complications.
PubMed: 35937594
DOI: 10.3389/fsurg.2022.919276 -
European Journal of Dentistry 2017Growth prediction plays a significant role in accurate diagnosis and treatment planning of orthodontics patients. It was hypothesized that the unique pattern of...
OBJECTIVE
Growth prediction plays a significant role in accurate diagnosis and treatment planning of orthodontics patients. It was hypothesized that the unique pattern of pneumatization of the frontal sinus as a component of craniofacial structure would influence the skeletal growth pattern and may be used as a growth predictor.
MATERIALS AND METHODS
A total of 144 subjects (78 females and 66 males) with a mean age of 19.26 ± 4.66 years were included in this retrospective study. Posterior-anterior and lateral cephalograms (LCs) were used to measure the frontal sinus dimensions. The skeletal growth pattern and relations of craniofacial structures were analyzed on LC using variables for sagittal and vertical analyses. Correlation between the frontal sinus dimensions and cephalometric indices was assessed by the Pearson's correlation coefficient.
RESULTS
The SN-FH and SNA angles had significant associations with frontal sinus dimensions in all enrolled subjects ( < 0.05). In males, the SN-FH, sum of posterior angles, Pal-SN, and Jarabak index were significantly associated with the size of frontal sinus ( < 0.05). In females, the associations of SN-FH and gonial angles with frontal sinus dimensions were significant ( < 0.05).
CONCLUSION
The results show that larger size of frontal sinus was associated with reduced inclination of the anterior cranial base, increased anterior facial height (in males), and increased gonial angle (in females) in the study population.
PubMed: 28435368
DOI: 10.4103/1305-7456.202630 -
Archives of Craniofacial Surgery Mar 2017Frontal sinus outflow tract (FSOT) injury may occur in cases of frontal sinus fractures and nasoethmoid orbital fractures. Since the FSOT is lined with mucosa that is... (Review)
Review
Frontal sinus outflow tract (FSOT) injury may occur in cases of frontal sinus fractures and nasoethmoid orbital fractures. Since the FSOT is lined with mucosa that is responsible for the path from the frontal sinus to the nasal cavity, an untreated injury may lead to complications such as mucocele formation or chronic frontal sinusitis. Therefore, evaluation of FSOT is of clinical significance, with FSOT being diagnosed mostly by computed tomography or intraoperative dye. Several options are available to surgeons when treating FSOT injury, and they need to be familiar with these options to take the proper treatment measures in order to follow the treatment principle for FSOT, which is a safe sinus, and to reduce complications. This paper aimed to examine the surrounding anatomy, diagnosis, and treatment of FSOT.
PubMed: 28913294
DOI: 10.7181/acfs.2017.18.1.1 -
Ear, Nose, & Throat Journal Apr 2023Nasal saline irrigation is the corner stone of postoperative care after functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis (CRS). However, intrasinus...
OBJECTIVES
Nasal saline irrigation is the corner stone of postoperative care after functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis (CRS). However, intrasinus penetration of the saline solution can be challenging and may require difficult head position, particularly for the frontal sinus. Our aim was to evaluate a novel device for direct intrasinus self-irrigation, usable at home for both maxillary and frontal sinus.
METHODS
Thirty devices were implemented in 23 patients: in the maxillary sinus for 18 patients and in the frontal sinus for 5 patients. The device was removed after 7 days on average (5-10 days), and nasal saline irrigation was carried on with a squeeze bottle for 6 weeks. Retrospective evaluation of the device included: device-related complication, patient satisfaction, and ostial or middle turbinate synechiae at 3 months.
RESULTS
No device-related complication (obstruction, displacement, infection, bleeding) occurred. Twenty-one (91.3%) patients were satisfied with the device. Two patients required the help of a nurse for irrigation. No ostial of middle turbinate synechiae was visualized at 3 months. This new endonasal device enables direct intrasinus self-irrigation after FESS for CRS.
CONCLUSION
This preliminary study showed that this device is safe and easy to use. However, further investigations are required to assess its potential role to reduce the risk of synechiae and revision surgery.
Topics: Humans; Frontal Sinus; Retrospective Studies; Endoscopy; Therapeutic Irrigation; Sinusitis; Saline Solution; Chronic Disease; Rhinitis
PubMed: 33645265
DOI: 10.1177/0145561320983942 -
Archives of Craniofacial Surgery Sep 2016Fractures of frontal sinus account for 5%-12% of all fractures of facial skeleton. Inadequately treated frontal sinus injuries may result in malposition of sinus... (Review)
Review
Fractures of frontal sinus account for 5%-12% of all fractures of facial skeleton. Inadequately treated frontal sinus injuries may result in malposition of sinus structures, as well as subsequent distortion of the overlying soft tissue. Such inappropriate treatment can result in aesthetic complaints (contour deformity) as well as medical complications (recurrent sinusitis, mucocele or mucopyocele, osteomyelitis of the frontal bone, meningitis, encephalitis, brain abscess or thrombosis of the cavernous sinus) with potentially fatal outcomes. Frontal contour deformity warrants surgical intervention. Although deformities should be corrected by the deficiency in tissue type, skin and soft tissue correction is considered better choice than bone surgery because of minimal invasiveness. Development of infection in the postoperative period requires all secondary operations to be delayed, pending the resolution of infectious symptoms. The anterior cranial fossa must be isolated from the nasal cavity to prevent infectious complications. Because most of the complications are related to infection, frontal sinus fractures require extensive surgical debridement and adequate restructuring of the anatomy. The authors suggest surgeons to be familiar with various methods of treatment available in the prevention and management of complications following frontal sinus fractures, which is helpful in making the proper decision for secondary frontal sinus fracture surgery.
PubMed: 28913266
DOI: 10.7181/acfs.2016.17.3.103 -
Journal of Neurosurgery. Case Lessons May 2021Osteomas of the paranasal sinuses are benign, slow-growing bone tumors that can cause a variety of clinical features depending on their size and location. Most osteomas...
BACKGROUND
Osteomas of the paranasal sinuses are benign, slow-growing bone tumors that can cause a variety of clinical features depending on their size and location. Most osteomas are asymptomatic and located in the frontal sinus. In rare cases, they may grow to extend into the cranial or orbital cavities, resulting in atypical presentations. The authors presented an aggressive case of a frontoethmoidal sinus osteoma with intracranial extension of an inflammatory sinonasal polyp.
OBSERVATIONS
A 30-year-old man with a history of chronic sinusitis presented to the hospital after three episodes of loss of consciousness, chronic worsening of headache, and decreased sense of smell. Rhinoscopic examination showed mucosal polyps arising from the infundibulum and the superior meatus. Computed tomography showed a fibro-osseous mass in the left frontal sinus. Subsequent brain magnetic resonance imaging with and without contrast revealed a large, septated intracranial left frontal lesion approximately 6.5 cm in diameter that was compressing the underlying brain parenchyma.
LESSONS
Intracranial extension of frontal sinus osteomas can have dire neurological implications. Early detection of lesions obstructing the paranasal sinuses outlet could prevent intracranial extension of the disease. The surgical approach to such tumors may be endonasal, open cranial, or a combination of both.
PubMed: 35854867
DOI: 10.3171/CASE21105