title: An Effective Method of Frontal Sinus Reconstruction After Bifrontal Craniotomy: Experience with 103 Patients.
abstract: BACKGROUND
  Bifrontal craniotomy is effective for the treatment of anterior skull base lesions. However, the frontal sinus (FS) is often opened during this surgery, and various postoperative complications may occur as a result of the open FS, including cerebrospinal fluid leakage and infection. We describe our procedure for maintaining the patency of the nasofrontal duct and direct suture of the exposed and violated FS mucosa.
  
  
  METHODS
  Bifrontal craniotomy with reconstruction of the FS was performed in 103 patients (68 women and 35 men; age range, 32-90 years; mean age, 62.6 years) for lesions including anterior cerebral artery aneurysm (100 cases), arteriovenous fistula (1 case), and meningioma (2 cases). After opening the FS, the mucosal membrane of the FS was dissected from the FS wall, and the orifice of the FS mucosa was closed with 7-0 monofilament running sutures. The nasofrontal duct was kept open by washing thoroughly to remove any bone dust and clot in the FS. The cavity of the FS was then packed with abdominal fat.
  
  
  RESULTS
  Postoperative cerebrospinal fluid leakage and mucocele formation did not occur in any patient. An intracranial infectious complication occurred in 1 patient (1.0%).
  
  
  CONCLUSIONS
  The present results indicate the effectiveness of our technique for the prevention of FS-related postoperative complications.
authors: Department of Neurosurgery, National Defense Medical College, Tokorozawa, Saitama, Japan; Department of Neurosurgery, Teishinkai Hospital, Sapporo, Hokkaido, Japan. Electronic address: s.takeuchi@room.ocn.ne.jp.
authors: Satoru
authors: S
authors: Takeuchi
authors: Department of Neurosurgery, Teishinkai Hospital, Sapporo, Hokkaido, Japan.
authors: Rokuya
authors: R
authors: Tanikawa
authors: Department of Neurosurgery, Abashiri Neurosurgical and Rehabilitation Hospital, Abashiri, Hokkaido, Japan.
authors: Makoto
authors: M
authors: Katsuno
authors: Department of Neurosurgery, Teishinkai Hospital, Sapporo, Hokkaido, Japan.
authors: Toshiyuki
authors: T
authors: Tsuboi
authors: Department of Neurosurgery, Teishinkai Hospital, Sapporo, Hokkaido, Japan.
authors: Kosumo
authors: K
authors: Noda
authors: Department of Neurosurgery, Teishinkai Hospital, Sapporo, Hokkaido, Japan.
authors: Junpei
authors: J
authors: Oda
authors: Department of Neurosurgery, Teishinkai Hospital, Sapporo, Hokkaido, Japan.
authors: Shiro
authors: S
authors: Miyata
authors: Department of Neurosurgery, Teishinkai Hospital, Sapporo, Hokkaido, Japan.
authors: Nakao
authors: N
authors: Ota
authors: Department of Neurosurgery, Teishinkai Hospital, Sapporo, Hokkaido, Japan.
authors: Hiroyasu
authors: H
authors: Kamiyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003399:Craniotomy / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005626:Frontal Sinus / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology / Q000628:therapy; D019651:Plastic Surgery Procedures / Q000379:methods*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000628:therapy; D013537:Sutures; D016896:Treatment Outcome
keywords: Bifrontal craniotomy; Cerebrospinal fluid; Complication; Frontal sinus; Infection