[Frontal sinusitis after transfrontal craniotomy: causes and management].
OBJECTIVE
To explore the causes, clinical manifestation and therapy of frontal sinusitis after transfrontal craniotomy.


METHODS
Thirty-three patients with frontal sinusitis after transfrontal craniotomy were included in the study. Among them, 7 cases had frontal sinus abscess and 4 cases had frontal sinus fistula. Twenty-three patients were treated with traditional frontal sinus surgery with facial incision. The nasofrontal dilatation tube was positioned for more than 3 months. Nine patients were treated with endoscopic frontal sinus surgery, and 1 patient was treated with combined endoscopic and traditional frontal sinus surgery, with nasofrontal dilatation tube positioned for less then 1 month. In the revision surgery, the bone wax and phlogistic acestoma were cleaned out in both operational methods. The causes of frontal sinusitis after transfrontal craniotomy were discussed by studying the frontal sinus CT image, and prior surgical data.


RESULTS
All patients were followed up for more than 6 months after the nasofrontal dilatational tube was removed. Among 33 patients, two cases with traditional frontal sinus surgery were operated twice due to nasofrontal dilatation tube fall off in 1 month. In all 33 patients, 30 cases cured and 3 cases got better. There were no curative difference between two operational methods.


CONCLUSIONS
The causes of frontal sinusitis after transfrontal craniotomy were inadequate sinus management in craniotomy and bone wax tamping in frontal sinus. There was more frontal sinus abscess and fistula occurring in frontal sinusitis after transfrontal craniotomy than that in ordinary frontal sinusitis. The therapy included cleaning out bone wax and phlogistic acestoma, and expanding the frontal sinus ostium. The satisfying curative effect was obtained in both operational methods, but endoscopic frontal sinus surgery was better because it is minimally invasive, no facial incision and quick recovery with less nasofrontal dilatational tube posting time.
Li
Shu-Hua
SH
Department of Otorhinolaryngology of Shenyang General Hospital of Chinese People's Liberation Army, Shenyang 110016, China. lishsy@sina.com
Shi
Hong-Jin
HJ
Dong
Wei-Dong
WD
Zou
Lian-Gui
LG
Wu
Da-Hai
DH
D000328:Adult; D003399:Craniotomy / Q000009:adverse effects*; D005260:Female; D005546:Forehead / Q000601:surgery; D015522:Frontal Sinusitis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000628:therapy