Bilateral Versus Unilateral Cranialization in the Management of a Breached Frontal Sinus

Micah Belzberg, Netanel Ben Shalom, Amir Wolff, Judy Huang, Chad Gordon

Research output: Contribution to journalArticlepeer-review

Abstract

Background:Frontal sinus breach during craniotomy may occur inadvertently or intentionally. Management of a breached frontal sinus is controversial as numerous operative techniques have been described. Frontal sinus breach may result in life-threatening complications, require additional surgeries, and increase the risk for long-term infectious sequelae. A literature review found a paucity of neurosurgical reports examining breached frontal sinus management or specific analyses of unilateral versus bilateral frontal sinus cranialization.Objective:A frontal sinus cranialization technique employed for patients involving frontal sinus breach and analyze outcomes managed with bilateral versus unilateral cranialization was presented in this study.Methods:A retrospective review of outcomes was performed using our Institutional Review Board-approved surgical case database between September 2012 and September 2018.Results:Thirty-three frontal sinus cranializations following frontal sinus breach were identified. Average follow-up time was 25 months. A statistically significant difference in postoperative infections was observed in patients with a history of previous cranial surgery who underwent unilateral compared to bilateral frontal sinus cranialization.Conclusion:These results suggest surgeons performing craniotomy or consulted intraoperatively for suspected frontal sinus breach should have a high suspicion for breached frontal sinus and a low threshold for frontal sinus cranialization. Furthermore, when performing frontal sinus cranialization, surgeons should consider performing bilateral, instead of unilateral, cranialization in patients with a history of previous craniotomy as bilateral cranialization was shown to decrease the risk of postoperative infection.

Original languageEnglish (US)
Pages (from-to)261-264
Number of pages4
JournalJournal of Craniofacial Surgery
Volume31
Issue number1
DOIs
StatePublished - Jan 1 2020

Keywords

  • Breach
  • cranialization
  • cranioplasty
  • frontal
  • management
  • outcomes
  • sinus

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

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