title: Endoscopic surgery in the treatment of crista galli pneumatization evolving with localizated frontal headaches.
abstract: BACKGROUND
  The crista galli is part of the ethmoid bone and thus may suffer from the process of pneumatization. Pneumatization occurs in between 3% and 14% of patients, resulting from air cells in the frontal or ethmoid sinuses.
  
  
  OBJECTIVE
  To describe 3 cases of crista galli pneumatization in which the patients developed infection and were treated surgically by endoscopic techniques.
  
  
  METHODS
  We present 3 case studies of patients complaining of severe frontal headaches. The patients underwent ENT evaluation, examination by video-endoscopy, and computed tomography, which identified crista galli pneumatization with mucosal thickening and the presence of fluid. Patients underwent treatment with antibiotics and corticosteroids; however, they showed no symptomatic improvement, displayed recurrence of symptoms, and maintained radiographic changes. Thus, patients then underwent drainage through the crista galli via an endoscopic procedure.
  
  
  CONCLUSIONS
  During surgery, mucopurulence and/or mucosal thickening and edema were identified in the pneumatized crista galli. There were no complications during or after surgery. Postoperatively, headache was improved in patients after a minimum follow-up of 6 months.
  
  
  CONCLUSIONS
  Crista galli pneumatization can result in infection, simulating rhinosinusitis. When there is little response to drug therapy, endoscopic surgical treatment is required; the current cases demonstrate that this technique is safe and effective.
authors.affiliation: Doctor of Otolaryngology Faculty of Medicine, University of Sao Paulo. Professor of Otorhinolaryngology in FURB - Regional University of Blumenau.
authors.forename: Jan Alessandro
authors.initials: JA
authors.lastname: Socher
authors.affiliation: Otolaryngologist.
authors.forename: Pedro Geisel
authors.initials: PG
authors.lastname: Santos
authors.affiliation: Student of Medicine in FURB - Regional University of Blumenau.
authors.forename: Vinicius Cidral
authors.initials: VC
authors.lastname: Correa
authors.affiliation: Student of Medicine in FURB - Regional University of Blumenau.
authors.forename: Leandro Caetano de Barros E
authors.initials: LC
authors.lastname: Silva
keywords: Headache; Natural Orifice Endoscopic Surgery; Video-Assisted Surgery