title: Cranialization of the frontal sinus for secondary mucocele prevention following open surgery for benign frontal lesions.
abstract: OBJECTIVE
  To compare frontal sinus cranialization to obliteration for future prevention of secondary mucocele formation following open surgery for benign lesions of the frontal sinus.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Tertiary academic medical center.
  
  
  METHODS
  Sixty-nine patients operated for benign frontal sinus pathology between 1994 and 2011.
  
  
  METHODS
  Open excision of benign frontal sinus pathology followed by either frontal obliteration (n = 41, 59%) or frontal cranialization (n = 28, 41%).
  
  
  METHODS
  The prevalence of post-surgical complications and secondary mucocele formation were compiled.
  
  
  RESULTS
  Pathologies included osteoma (n = 34, 49%), mucocele (n = 27, 39%), fibrous dysplasia (n = 6, 9%), and encephalocele (n = 2, 3%). Complications included skin infections (n = 6), postoperative cutaneous fistula (n = 1), telecanthus (n = 4), diplopia (n = 3), nasal deformity (n = 2) and epiphora (n = 1). None of the patients suffered from postoperative CSF leak, meningitis or pneumocephalus. Six patients, all of whom had previously undergone frontal sinus obliteration, required revision surgery due to secondary mucocele formation. Statistical analysis using non-inferiority test reveal that cranialization of the frontal sinus is non-inferior to obliteration for preventing secondary mucocele formation (P<0.0001).
  
  
  CONCLUSIONS
  Cranialization of the frontal sinus appears to be a good option for prevention of secondary mucocele development after open excision of benign frontal sinus lesions.
authors.affiliation: Department of Otolaryngology, Head & Neck and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Gilad
authors.initials: G
authors.lastname: Horowitz
authors.affiliation: Department of Otolaryngology and Head & Neck Surgery, Rambam Medical Center, Haifa, Israel.
authors.forename: Moran
authors.initials: M
authors.lastname: Amit
authors.affiliation: Department of Otolaryngology, Head & Neck and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Oded
authors.initials: O
authors.lastname: Ben-Ari
authors.affiliation: Department of Otolaryngology and Head & Neck Surgery, Rambam Medical Center, Haifa, Israel.
authors.forename: Ziv
authors.initials: Z
authors.lastname: Gil
authors.affiliation: Department of Otolaryngology, Head & Neck and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Abraham
authors.initials: A
authors.lastname: Abergel
authors.affiliation: Department of Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Nevo
authors.initials: N
authors.lastname: Margalit
authors.affiliation: Department of Otolaryngology, Head & Neck and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Oren
authors.initials: O
authors.lastname: Cavel
authors.affiliation: Department of Otolaryngology, Head & Neck and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Oshri
authors.initials: O
authors.lastname: Wasserzug
authors.affiliation: Department of Otolaryngology, Head & Neck and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Dan M
authors.initials: DM
authors.lastname: Fliss
mesh_terms: D000328:Adult; D005260:Female; D005626:Frontal Sinus / Q000601:surgery*; D006801:Humans; D008297:Male; D009078:Mucocele / Q000517:prevention & control*; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013524:Surgical Flaps