• Archives of Plastic Surgery
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• v.33 no.2
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• pp.252-254
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• 2006

The dermoid cyst is the one of common space occupying orbital lesion. This lesion is regarded as a non-invasive tumor, but infrequently causes destruction of adjacent bony structure and displacement of adjacent tissue. We experienced a characteristic ovoid orbital dermoid cyst that occupied in the frontal sinus and causes displacement of the eyeball with well-defined lining. This 55-year-old male presented a mass in left orbit, which rapidly increased in size for past 12 months, and patient could not open left eyelid. We removed this tumor totally then reconstructed the orbital roof and frontal sinus with an iliac bone graft and polyethylene sheet(Medpor Newnan, USA). This patient was followed up for 12 months and patient obtained satisfactory result without any complication suck as recurrence or infection.

• Archives of Plastic Surgery
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• v.41 no.6
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• pp.679-685
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• 2014

Background Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are still controversial. In this article, we suggest a simple reduction method using a subbrow incision as a treatment for isolated anterior sinus fractures. Methods Between March 2011 and March 2014, 13 patients with isolated frontal sinus fractures were treated by open reduction and internal fixation through a subbrow incision. The subbrow incision line was designed to be precisely at the lower margin of the brow in order to obtain an inconspicuous scar. A periosteal incision was made at 3 mm above the superior orbital rim. The fracture site of the frontal bone was reduced, and bone fixation was performed using an absorbable plate and screws. Results Contour deformities were completely restored in all patients, and all patients were satisfied with the results. Scars were barely visible in the long-term follow-up. No complications related to the procedure, such as infection, uncontrolled sinus bleeding, hematoma, paresthesia, mucocele, or posterior wall and brain injury were observed. Conclusions The subbrow approach allowed for an accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by providing a direct visualization of the fracture. Considering the surgical success of the reduction and the rigid fixation, patient satisfaction, and aesthetic problems, this transcutaneous approach through a subbrow incision is concluded to be superior to the other reduction techniques used in the case of an anterior table frontal sinus fracture.

• Archives of Craniofacial Surgery
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• v.18 no.4
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• pp.230-237
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• 2017

Background: The traditional approach for reduction of frontal sinus fractures is coronal incision. Inherent complications of the coronal approach include long scar, hair loss, and long operation time. We describe a simple approach for the reduction of frontal sinus anterior wall fractures using a suprabrow incision that is commonly used for brow lift. Methods: From March 2007 to October 2016, the authors identified patients with anterior wall frontal sinus fractures treated by open reduction through a suprabrow incision. Only cases with photographic/radiographic documentation and a minimum follow-up of 6 months were included. The incision line was designed to be at the upper margin of the eyebrow. Medical records and radiographic data were retrospectively reviewed. Surgical outcomes, cosmetic results, and complication were assessed. The patient scale of the patient and observer scar assessment scale was used to assess patient satisfaction for incisional scar at the 6-month follow-up. Results: Thirty-one patients underwent fracture reduction through a suprabrow approach during the study period, with a mean follow-up of 41 months. No patients showed any recurrent displacement, eyebrow asymmetry, or infection during follow-up. Thirteen patients reported their forehead paresthesia postoperatively, and 12 of them had preoperative symptom. One patient complained of incisional scar and underwent scar revision. All patients were satisfied with their eyebrow and forehead contour. Conclusion: The suprabrow approach allowed for an accurate reduction of the fractures in the anterior wall frontal sinus by providing direct visualization of the fracture. This transcutaneous approach can effectively restore forehead contour with acceptable postoperative complications and patient satisfaction.

• Anatomy and Cell Biology
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• v.56 no.2
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• pp.179-184
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• 2023

The Functional endoscopic sinus surgery through transnasal approach is a common modality of treatment for disorders of the nasal cavity, paranasal air sinuses as well as cranial cavity. The olfactory fossa (OF) is located along the superior aspect of cribriform plate which varies in shape and depth. This variable measurement of the depth of OF is mostly responsible for greater risk of intracranial infiltration during endoscopic procedures in and around the nasal cavity. The morphology of frontal and ethmoid sinus (ES) vary from simple to complex. This cadaveric study is planned to improve the ability of the otolaryngologist, radiologist to understand the possible morphological variations and plan steps of less invasive "precision surgery" to have a safe and complication free procedures. A total of 37 human head regions were included in the study. For classification of OF, Modified Kero's classification was used. The size, shape and cells of frontal and ES were noted. We found, type II (60.8%) OF was more common followed by type I (29.7%) than type III (9.5%). The shape of frontal sinus was comma shaped (55.4%) followed by oval (18.9%) than irregular (16.2%). Most common two cells type of ES was seen in 50.0% of both anterior and posterior ES. Out of 74 ES, 8.1% of Onodi cells and 14.9% of agger nasi cells were seen.

• Archives of Craniofacial Surgery
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• v.22 no.1
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• pp.52-55
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• 2021

Complete surgical excision within a margin of normal healthy bone is the treatment of choice for intraosseous hemangioma. A 56-year-old man visited with complaints of a firm, mildly tender, immovable, and palpable mass on the right forehead (size: 1.5×1.5 cm). Non-contrast brain computed tomography performed preoperatively revealed a 1.5 cm heterogenous osteolytic lesion with suspected internal trabeculation in the right frontal bone. Under general anesthesia, a 2 cm transverse incision was made on the forehead skin rather than bicoronal incision. Full-thickness en bloc resection of the frontal bone including the mass was performed. The frontal bone was removed with care taken not to damage the frontal sinus mucosa. The frontal sinus was sealed with a collagen patch (Tachocomb) and a cranioplasty was performed using bone cement. At 6 months postoperative, a clean wound was confirmed without any complications, and there was no local recurrence. Surgical excision of intraosseous hemangioma in the frontal sinus bone can be performed via direct incision or the bicoronal approach. In this case, the direct incision approach was used to achieve smaller scars and faster recovery than the bicoronal approach.

• Archives of Craniofacial Surgery
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• v.15 no.3
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• pp.129-132
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• 2014

Facial skeletal remodeling was revolutionized more than 30 years ago, by the work of Tessier and other craniofacial surgeons. However, the need to correct the skeleton in the upper third of the face is not frequently diagnosed or treated in aesthetic facial surgery. Here, we report on the aesthetic correction of a protrusive forehead. A patient visited our hospital for aesthetic contouring with a prominent forehead. The anterior wall of the frontal sinus was removed with a craniotome via the bicoronal approach. After the excised bone was repositioned, it was fixed with a titanium mesh plate and screws. An electric burr was used to contour the supraorbital rim and frontal bone. Once the desired shape was achieved, the periosteum was replaced, and the wound was closed in layers. When performed properly, frontal sinus contouring could significantly improve the appearance in patients with a prominent forehead. Plastic surgeons must carefully evaluate patients with a prominent forehead for skeletal remodeling that involves the accurate and safe repositioning of the anterior wall of the frontal sinus.

• Journal of Korean Neurosurgical Society
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• v.29 no.3
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• pp.353-359
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• 2000

Objective : The fracture on the frontal bone in head-injured patients may be commonly encountered in the clinical situations. Biomechanical studies demonstrate that the anterior wall of the frontal sinus is intermediate in its ability to resist fracture on direct impact. If the frontal sinus is large and the anterior table is able to disperse the force of the impact over a greater area, the posterior table and intracranial contents usually can be spared. We analyzed the clinical features of the patients who presented with frontal skull fracture due to frontal blows. Patients and Methods : From January, 1992 to December, 1997, 172 patients with frontal skull fracture were selected among 1911 patients with head injury who were admitted to department of neurosurgery. Clinical records and radiological studies of all patients were reviewed and evaluated retrospectively. Results : The neurobehavioral changes was seen in 34 cases(19.8%) and showed statistical significances in case of facial bone fractures, acute subdural hematoma(SDH), and positive frontal lobe releasing sign(p<0.05). The good glasgow outcome score group(GOS, good recovery & moderate disability) at discharge was revealed in 77.3% of total patient population. The poor GOS group(severe disability & vegetative state & death) at discharge was revealed in 22.7%. The poor GOS group at discharge have statistical significances with acute epidural hematoma(EDH), traumatic intraventricular hemorrhage(t-IVH), traumatic intracranial lesion, poor initial glasgow coma scale(GCS) scores & Revised Trauma Score(RTS)(p<0.05). Conclusion : Because of their anatomical relationships and neurobehavioral patterns due to vulnerability of the frontal lobe, the frontal injury should be considered as complicated facial injuries. Therefore, these patients are more likely to have a cosmetic or neuropsychiatric problems.

• Journal of Veterinary Clinics
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• v.16 no.1
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• pp.226-229
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• 1999

A 4-year old male Pitbull terrier dog was presented with a history of nasal discharge of left side and dyspnea for 3 days. This dog had a bitewound on the head due to dog-fighting two weeks ago. There was no abnomality except mild anemic sign on blood examination. Frontal projection of radiographs was taken. This was diagnosed as frontal sinusitis. After skin incision on frontal head, a silicone tube was inserted into the affected frontal sinus. Abscess of the frontal sinus was drainaged and irrigated with saline solution containing trypsin and cephazolin. This patient who also treated with enrofloxacin was recovered completely.

• Journal of the korean veterinary medical association
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• v.15 no.8
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• pp.463-466
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• 1979

In treatment of empyema of frontal sinus in a dairy cow, modified trephing method was applied and aquired satisfactory drainage of pus and discharge from frontal sinus. Methods of trephing opening applied were as follows : 1. Site of trephing opening for

• Archives of Craniofacial Surgery
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• v.15 no.3
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• pp.125-128
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• 2014

Malignant peripheral nerve sheath tumors are extremely rare soft tissue sarcomas. Among various locations, the trunk and extremities are the most commonly involved sites, with only 15% of such lesions occuring in head and neck region. Here, we report a case of a 74-year-old male who presented with forehead swelling and right eye deviation. Computed tomography images revealed a tumor involving the frontal sinus, ethmoid sinus, and the orbital cavity. The patient underwent a surgical excision of the lesion, which histopathological examination revealed to be a malignant peripheral nerve sheath tumor.