Reconstruction of the Forehead and Frontal
Cavity
Doležal P., Barta T., Profant M., Berkovič J., Tedla M.
Klinika ORL LF UK, FN a SPAM, Bratislava, prednosta prof. MUDr. M. Profant, CSc. |
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Summary:
Reconstruction of the forehead and frontal cavity is necessary in case of injury, tumour
and chronic inflammation in this region. From 1996 to 2001 19 patients were operated on for frontal
fracture (12) tumour (6) and frontal sinusitis (1). The postoperative bone defect was reconstructed
in all cases. Several approaches were used. In the case of injury with torn skin the operative field
was reached through the wound. Eyebrow incision was used in 7 cases, eyebrow incision with skin
incision in nasal root in 5 cases, and coronal incision with scalp stripping was used in 5 cases where
wide frontal exposure was desired. Impression fracture of the frontal bone was managed either by
elevation and fixation of bony fragments using permanent suture material or metal splints. Initially
a bony graft from the iliac crest, or rib cartilage was used for reconstruction of a large bony defect,
now metal titanium minisplints and mesh are used instead. In three cases the anterior frontal wall
was destroyed by big osteoma and there was no healthy bone suitable for reconstruction. On patient
suffered from hyperostosis, which had to be removed. Aesthetic results were very good in all but
one patient and a second operation because of sinusitis was required in two patients. In patients
with frontobasal fractures with liquorrhea and a damaged posterior wall cooperation with a neurosurgeon is neccessary. Peroperative revision of the frontonasal duct is recommended.
Key words:
forehead reconstruction, frontobasal injury, titanic minisplints, hyperostosis.
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