title: Correction of a contour deformity associated with frontal pneumosinus dilatans using surgical navigation technology.
abstract: Pneumosinus dilatans (PD) is a pathologic hyperaeration of the paranasal sinuses of unknown etiology. Although benign itself, PD has been associated with a number of serious concomitant conditions, including meningioma, optic nerve tumors, and visual loss. Patients with PD often present with cosmetic complaints, desiring recontouring of the facial bones to achieve an improved appearance of the face. The present case illustrates one of the first attempts at intraoperative surgical navigation to map the frontal sinus during correction of the facial deformity caused by PD. The navigation device was used to give the surgical team real-time information during the case to prevent violation of the posterior table of the frontal sinus, allowing for facial bone contouring to occur in a more efficient and safer manner by way of accurate osteotomy placement with no wasted bone for reconstruction and no accidental intracranial involvement.
authors.affiliation: Resident, Division of Plastic Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: jaricci@partners.org.
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Ricci
authors.affiliation: Resident, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Naman S
authors.initials: NS
authors.lastname: Desai
authors.affiliation: Attending Surgeon, Manhattan Aesthetic Surgery, New York, NY.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Vendemia
mesh_terms: D000328:Adult; D019412:Anatomy, Cross-Sectional; D001860:Bone Plates; D003399:Craniotomy / Q000295:instrumentation / Q000379:methods; D004108:Dilatation, Pathologic; D057918:Fiducial Markers; D005624:Frontal Bone / Q000601:surgery*; D005626:Frontal Sinus / Q000601:surgery*; D006801:Humans; D008297:Male; D016343:Monitoring, Intraoperative; D010254:Paranasal Sinus Diseases / Q000601:surgery*; D010347:Patient Care Planning; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods