Use of anteriorly based pericranial flap in frontal sinus obliteration

Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Alberta, Edmonton, Alberta, Canada.
Otolaryngology Head and Neck Surgery (Impact Factor: 2.02). 10/2006; 135(3):413-6. DOI: 10.1016/j.otohns.2006.03.041
Source: PubMed


In an era of endoscopic sinus surgery, frontal sinus obliteration continues to remain an important treatment option in chronic frontal sinus disease. Numerous avascular obliterative materials including fat, muscle, cancellous bone, and hydroxyapatite have been used in this procedure. In this article, we describe a vascularized anteriorly based pericranial flap to obliterate frontal sinus.
Retrospective chart review of patients referred to tertiary care hospital between 1996 and 2003.
Records of the patients who underwent this procedure were reviewed. Demographics, indications, and immediate and late complications were recorded. A phone questionnaire was used to assess patient satisfaction with the outcome.
A total of 12 patients underwent frontal sinus obliteration with this technique. Mean follow-up was 40 months. None of the patients developed recurrent frontal sinusitis. All of the patients were pleased with the outcome.
Pericranial flap is a highly vascularized flap that is easily harvested and is an effective and viable modality for obliterating frontal sinus. EBM rating: C-4.


Available from: Hadi Seikaly, Dec 27, 2014
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    ABSTRACT: This study evaluates non-standardized subjective patient satisfaction- and clinical outcome variables following frontal sinus obliteration with abdominal fat in endoscopically inaccessible mucoceles. In a retrospective chart review, all patients who underwent frontal sinus obliteration for endoscopically inaccessible mucoceles at the Ludwig Maximilian University in Munich between 1996 and 2006 were identified and the postoperative outcomes were evaluated by a non-standardized patient questionnaire rating the degree of symptoms before and after surgery. Additionally, the postoperative clinical status and MRI-scans were analysed in a subgroup of patients. Nine out of 10 patients were generally satisfied with the obliteration. Most had a significant improvement in their main symptoms and reported a decrease in annual days of missed work and a reduced use of disease-specific drugs. The sense of smell and the intensity of postnasal dripping remained subjectively unchanged. Seventy percent of patients complained about temporary pain at the abdominal donor side. Based on these results, osteoplastic frontal sinus obliteration using abdominal fat seems to be a successful treatment option in patients in whom mucoceles of the frontal sinus are not endoscopically accessible.
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    ABSTRACT: Even with the widespread use of minimally invasive endoscopic sinus surgery, the treatment of complicated frontal sinus disease remains very challenging, and obliteration of the sinus often is indicated. A variety of materials have been used for obliteration of the frontal sinus; however, the search for the ideal technique persists. The well-vascularized anteriorly based pericranial flap, described in this article, is a safe, effective, and viable method of frontal sinus obliteration.
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