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At least 19 recordsLinked to original sources
PubMed1991

Hydroxyapatite cement. II. Obliteration and reconstruction of the cat frontal sinus.

Frontal sinus obliteration and reconstruction can be performed with autogenous grafts or synthetic implants, each of which has significant limitations. Hydroxyapatite cement, which can be shaped intraoperatively and sets to a microporous hydroxyapatite implant, was applied to this problem. Nine cats had the anterior table of their frontal sinus unilaterally removed and the sinus cavity stripped of its mucosa. Hydroxyapatite cement was used to obliterate the cavity and reconstruct the overlying anterior table defect. The unoperated side served as the control, and the animals were sacrificed up to 18 months postoperatively. There were no adverse reactions, infections, mucoceles, or implant extrusions. The normal anatomic contour of the forehead region overlying the hydroxyapatite cement implants was maintained in all animals. Histologic examination of undecalcified whole sinus sections revealed progressive replacement of the implants with woven bone without a loss of volume. Replacement of the hydroxyapatite cement by woven bone is postulated to occur through a combination of implant resorption coupled with osteoconduction. The use of hydroxyapatite cement proved successful for the reconstruction and obliteration of cat frontal sinuses, and may be appropriate for the same application in humans.

Animals↗
PubMedDate not supplied

Fibrous xanthoma of the frontal sinus.

Frontal sinus mucocele was our preoperative diagnosis in a patient who had frontal swelling and downward displacement of the eye. Supporting this were typical roentgenogram changes, a long history of asthma, pansinusitis, and previous multiple-polypectomy surgery. Frontal sinus exploration revealed a locally eroding lesion. It was composed of spindled cells and lipid-laden histiocytes with a pattern of fibrous xanthoma and was treated conservatively. It should not be confused with true malignancies such as fibrous histiocytoma having a similar histopathologic appearance and requiring more aggressive surgical treatment.

Fibroma↗
PubMed1986

Frontal sinus fracture following osteoplastic frontal sinus obliteration.

A patient who sustained frontal sinus fracture and who earlier had undergone an osteoplastic fat obliteration procedure is described. The literature is reviewed and recommendations are made for management of this and other cases of frontal sinus fractures with posterior table involvement.

Athletic Injuries↗
PubMed1989

Radionuclide bone scan in frontal sinus osteoma.

Frontal sinus osteomas, whether cortical or cancellous by morphologic radiologic appearance, appear to represent metaplasia rather than neoplasia occurring at the frontal-ethmoid suture line. These osteomas are not infrequently found completely or partially within the frontal sinus or adjacent ethmoid complex. Regardless of specific anatomic site, they occur at the embryologic junction of enchondral and membranous frontal bone. Those osteomas which produce mechanical complications (ostial obstruction or facial deformity or proptosis) give clear indication for surgical intervention. A much larger group of osteomas, however, is detected on routine plan radiographic examinations carried out for other reasons. Unfortunately, the singular conventional radiographic finding of an osteoma has, in the past, frequently been the sole and primary indication for surgical intervention. The purpose of the present paper was to review the experience with 10 frontal sinus osteomas managed expectantly over the past 11 years. All were imaged serially with morphologic studies, including conventional X-rays and computerized tomography scans. A radionuclide bone scan was carried out in all patients at the time of initial presentation. Those identified as producing mechanical complications clinically, or a 'hot' bone scan by radionuclide study, were regarded as appropriate for osteoplastic frontal sinusectomy for removal of the osteoma; three cases were approached in this way. On the other hand, utilizing this physiologic imaging parameter, a 'cold' bone scan indicated the presence of a relatively insert osteoma, in terms of biologic growth activity. Thus, adopting a non-operative approach, and following these patients over the 4-11 year period appears to have been validated.(ABSTRACT TRUNCATED AT 250 WORDS)

Diagnosis, Differential↗
PubMed1989

Use of a Foley catheter for short-term drainage in frontal sinus surgery.

Frontal sinus surgery for chronic disease presents a variety of problems, in particular that of drainage. No matter how successful the surgical technique is in clearing disease from the sinus, it is still important that the fronto-nasal duct is kept patent unless the procedure is an obliterative one. Usually a tube is inserted for drainage and has to be kept in place for several weeks or months. This paper presents a study of 16 patients, suffering from frontal sinus disease, in whom a short-term drainage technique using a Foley catheter was employed between 1979 and 1988 at Lagos University Teaching Hospital, Nigeria. This type of drainage allows effective anchorage and irrigation with a decongestant. It has been found to give satisfactory results after 14 days in place and has had no unusual complications. It is therefore recommended for use in such cases.

Catheterization↗
PubMed1979

Anterior table frontal sinus fractures.

Frontal sinus fractures cover a spectrum of injury. A series of 52 primarily treated patients from the University of Cincinnati Medical Center is presented. Initial systematic management was applied to these patients and consisted of complete radiographic evaluation supplemented by wound care and cosmetic restoration when needed. All patients were followed on a long-term basis; both clinically and radiographically. Results to date are that 49 patients have had an uneventful post-traumatic course with re-establishment of normal sinus aeration. From the cosmetic standpoint no contour revisions have been needed and only two patients required elective scar revision. Three patients developed chronic suppurative sinus disease within the first post-traumatic year which was readily diagnosed and managed without complication by osteoplastic frontal sinusotomy and adipose obliteration.

Adolescent↗
PubMed1975

Frontal sinus cancer manifested as a frontal mucocele.

During the period 1972 to 1974, 12 frontal mucopyoceles were seen. Subsequently, three were shown to have an underlying neoplasm. Evaluation of the roentgenograms demonstrated minor differences between those with and those without a malignant basis. In previous reports of frontal sinus cancer, the descriptions of the roentgenograms suggest that it is possible that these features were also present. The difficulty in deciding the sinus of origin in such cancers has often been discussed, but the possibility that neoplasms of the orbital lobe of the lacrimal gland may occur in the frontal sinus is usually not considered. Anatomically, the intimate proximity of this lobe to the frontal sinus suggests that a neoplasm could develop in this manner. I believe that this was true in two of the patients reported herein.

Adenocarcinoma↗
PubMed1985

Resection of the interfrontal sinus septum in chronic or recurrent frontal sinusitis. Pre- and post-operative evaluation of the naso-frontal duct.

In 9 patients with recurrent attacks of acute or chronic frontal sinusitis, interfrontal sinus septum resection was performed. In 5 patients there was unilateral disease and in 4 bilateral. As all patients had previously had their frontal sinus trephined, pre- and post-operative naso-frontal duct function tests were performed. Pre-operatively, of 11 naso-frontal ducts tested (2 patients bilaterally) not one showed air flow on spontaneous respiration. Passage of air was obtained at forced inspiration and expiration in one patient and by Valsalva's manoeuvre in 6. No flow of air whatsoever was obtained in 4 of the ducts, whatever the method used. At follow-up performed 1-8 years post-operatively 7 out of the 9 patients had no frontal sinus problems. The remaining 2 patients, who both had nasal allergy, were improved. Post-operative testing of the 9 patients showed flow of air on spontaneous respiration in 4 patients, whereas 4 needed forced inspiration or expiration and only one patient Valsalva's manoeuvre. The sinus septum resection, which is very simple to perform, is a good alternative to more extensive frontal sinus surgery but may be of less value in patients with nasal allergy.

Acute Disease↗
PubMed1985

[Squamous cell carcinoma of the frontal sinus caused osteomyelitis of the frontal bone].

A case of the squamous cell carcinoma of the frontal sinus complicated with osteomyelitis of the frontal bone was reported. A 47-year-old male was admitted to Asahikawa Medical College Hospital because of a bulging of forehead and remittent fever of a six-month history and general convulsive seizures on the day before admission. On physical examination, a bulging of forehead with redness, tenderness and fluctuation was noted. Sense of smell diminished bilaterally. Oto-laryngological examination disclosed paranasal sinusitis. Skull X-P and CT scan suggested osteomyelitis of the frontal bone secondary to frontal sinusitis. However, a frontal sinus tumor with osteomyelitis was also possible. Operation was performed and a granulomatous mass attached to the dura with thick epidural abscess was noted. The mass and affected bone edge were removed. Pathological examination of the specimens disclosed findings of squamous cell carcinoma and osteomyelitis. Recurrence of the tumor rapidly occurred and reoperation was performed a month after the first operation. Postoperative irradiation and chemotherapy with pepleomycin were done but failed to control the growth and recurrence occurred immediately. The tumor penetrated the skin of the forehead and the patient died of cachexy 7 months after the first surgery. Osteomyelitis usually occurred in the metaphysis of long tubular bone and rarely in short bone or flat bone such as a skull. This is attributed to the difference of distribution of the bone marrow vessels. Embolization and subsequent growth of bacteria in the blood flow is less liable to occur in short bone and flat bone.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Squamous Cell↗
PubMed1987

Nasofrontal duct: CT in frontal sinus trauma.

Radiologic evaluation of frontal sinus fractures is instrumental in determining the need for surgery. Computed tomography (CT) is an excellent modality for evaluation of frontal sinus trauma, particularly for anterior and posterior wall fractures. However, fractures of the nasofrontal duct are more difficult to delineate, and judgments about operating for this problem are often made on less than concrete evidence of duct trauma. To evaluate the usefulness of CT in identifying nasofrontal duct trauma, a two-part study was done. First, CT was performed on cadavers to study the anatomic relationship of the nasofrontal duct to midface anatomy. Then, a retrospective study was performed in 19 patients with suspected frontal sinus fractures who underwent frontal sinus surgery. Findings at surgery were compared with preoperative evaluation with CT. Correlations were identified and criteria developed that can be used to identify patients needing surgical intervention in frontal sinus trauma. These criteria include findings of either a fracture involving the base of the frontal sinus or a fracture of the anterior ethmoid complex, or both.

Adolescent↗
PubMed1986

Frontal sinus obliteration using liposuction.

Frontal sinus obliteration is performed for a variety of reasons, including chronic sinus disease, traumatic injuries, mucoceles, and osteomas of the sinus. Once the decision is made to obliterate the sinus, it is paramount that all mucosal remnants be removed and that the material used to fill the irregular expanses of the frontal sinus help prevent recurrence of the disease process. The materials most commonly used for this purpose are fat, muscle, and pericranium. Fat obtained from the abdomen, gluteal area, or lateral thigh is probably the most frequently used substance. The procurement of fat in the traditional way adds significant time to the operation and is associated with significant morbidity at the donor site. Fat obtained in this manner is often bulky and does not truly conform to the sinus contour. In an attempt to minimize operating time and donor-site morbidity--as well as obtain a more malleable graft--we used liposuction to obtain our fat grafts for sinus obliteration. Using this method, we were able to obtain an adequate amount of tissue from either the abdomen or lateral thigh in all patients. We have used this technique in eleven patients, with follow-ups ranging from 3 to 18 months. We have had no donor-site morbidity and (to date) there has been no recurrence of sinus disease in these patients. While the follow-up period is not adequate for final evaluation in these patients, we believe this is a valuable adjunct to frontal sinus surgery.

Adipose Tissue↗
PubMed1990

Bilateral congenital cysts in the frontal sinuses of a horse.

Congenital frontal sinus cysts were found bilaterally in the frontal sinuses of a one-year-old miniature horse. Diagnosis was based on radiography of the head and cytologic examination of tissue aspirated from the frontal sinuses. The cysts were surgically removed, using a hinged bone flap technique bilaterally over the frontal sinuses.

Animals↗
PubMed1990

The effect of early fronto-orbital advancement on frontal sinus development and forehead aesthetics.

The frontal sinuses make an important contribution to normal forehead and glabellar contour. This study was designed to test our clinical impression that early fronto-orbital ("frontal bone") advancement could have an adverse effect on frontal sinus development and consequently on forehead aesthetics. A retrospective study was conducted on 11 patients who had undergone fronto-orbital advancement and also had a long period of follow-up at the Institute of Reconstructive Plastic Surgery at New York University. The longitudinal cephalometric data were compared with unoperated controls. With one exception, no patient who underwent bilateral fronto-orbital advancement developed a frontal sinus, and all such patients had a flattened brow contour when compared with unoperated patients, of whom 82 percent developed at least one frontal sinus. Of the three patients who underwent unilateral fronto-orbital advancement for plagiocephaly (flattened forehead), two developed a frontal sinus but only on the unoperated side and one developed bilateral frontal sinuses. The two patients with unilateral frontal sinus development had a particularly obvious deformity resulting from normal glabellar projection on the unoperated side and a flattened contour on the operated side. Fronto-orbital advancement affects forehead aesthetics and should be performed only in infant patients with moderate to severe deformities. patients with plagiocephaly whose deformity is sufficiently severe to warrant surgery should preferably undergo bilateral fronto-orbital advancement (by the technique described) rather than unilateral advancement in order to avoid the brow asymmetry that results from unilateral frontal sinus development.

Adolescent↗
PubMed1988

[Frontal lobe abscess as a complication of frontal sinus osteoma].

A frontal brain abscess was caused by an osteoma of the frontal sinus. This osteoma had destroyed the posterior wall and was blocking the infundibulum. Under these preconditions a sinusitis frontalis was followed by an intracranial infection and a brain abscess.

Adult↗
PubMed1990

A 'silent' intracranial complication of frontal sinusitis.

Intracranial complications of frontal sinusitis, although rare today, do still develop despite widespread use of antibiotics. We report a case which demonstrates how silently a frontal lobe abscess may present with subtle changes in mood and behaviour, with no focal neurological signs. Diagnosis and management are discussed and a brief review of the incidence of intracranial complications of frontal sinusitis, mode of spread, clinical presentation, investigations, treatment and bacteriology is presented.

Adult↗
PubMed1986

Acute frontal sinusitis after lacrimal surgery.

Acute frontal sinusitis occurred in four patients who required removal of the anterior portion of the middle turbinate to provide adequate intranasal drainage during lacrimal surgery. Three patients with redness and swelling around the wound were initially thought to have wound infection, but localized tenderness to percussion of the frontal sinus and air fluid levels on x-rays indicated acute frontal sinusitis. Treatment with antibiotics and steroids gave relief. Use of unipolar electrocautery to excise the middle turbinate probably caused acute inflammation of the frontonasal duct. We recommend simple excision without electrocautery in those cases requiring removal of turbinate for successful lacrimal surgery.

Acute Disease↗
PubMed1985

Frontal sinusitis--a 10 year experience.

Frontal sinusitis follows upper respiratory infections, sinus trauma, and swimming. Complications, often life threatening, still occur although less frequently than in the pre-antibiotic era. The course of 40 patients admitted to St. Michael's Hospital with a diagnosis of frontal sinusitis between the years 1973-83 is reviewed. The regional complications as well as the surgical procedures required to manage these problems are discussed. The osteoplastic flap with obliteration of the sinus cavity by osteoneogenesis has become the procedure of choice in dealing with most cases of chronic frontal sinusitis.

Adolescent↗