3.13\ Frontal Sinus Cranialization

3.13.1\ Discussion

Cranialization of the frontal sinuses is performed when there is disruption of the posterior wall of the frontal sinus, which can be secondary to

a

mucoceles, trauma, arteriovenous malformations, or infection, and serves to incorporate the frontal sinus into the intracranial compartment. The procedure involves mucosal exenteration, irrigation, cranialization, and packing of the residual frontal sinus cavity and frontonasal drainage pathway using various materials (Fig. 3.42).

b

Fig.3.42  Frontal sinus cranialization. The patient incurred facial fractures, which involved the frontal sinuses, which is shown to be opacified on the preoperative sagittal CT image (a). Postoperative sagittal CT image (b) shows

interval frontobasal craniotomy for removal of the inner table of the frontal sinus and insertion of bone paste (arrow) to eliminate the connection with the rest of the sinonasal cavities