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Abstract
A 27-year-old male complaining of anterior frontal swelling and pain was sent to our hospital for further examination and treatment. Examinations, including X-ray, CTscan, MRI, led to a diagnosis of frontal sinusitis with bone defect of the anterior wall and a fistula between the frontal sinus and the skin. After radical maxilloethmoidectomy, an extranasal frontal sinus operation employing a coronal incision was performed under general anesthesia. A bone defect was found in the medio-superior portion of the left frontal sinus. The defect connected with the fistula to the frontal skin as an extension of the frontal sinus lesion. After complete removal of the inner wall lesions in the frontal sinus and nasofrontal duct, the latter was plugged with autogenous iliac bone grafts. Then autogenous abdominal fat was implanted into the frontal sinus. The anterior wall of the frontal sinus was reconstructed with an iliac bone graft. During the 34 months since surgery, he has had no recurrent infection and no cosmetic or functional problem. In conclusion, frontal sinus surgery via a coronal incision approach is feasible when a wide surgical field with direct visualization of the frontal sinus is required, and it can produce satisfactory results.
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