Development of the frontal sinus following bilateral fronto-orbital osteotomies

• Published in: Journal of cranio-maxillo-facial surgery 1998-06, Vol.26 (3), p.129-135
• Main Authors: Locher, Michael C., Sailer, Hermann F., Haers, Piet E., Carls, Friedrich R., Oechslin, Christian K., Grätz, Klaus W.
• Format: Article
• Language: English
• Subjects: Age Factors; Biological and medical sciences; Bone Remodeling; Cephalometry; Child; Child, Preschool; Craniofacial Dysostosis - surgery; Craniosynostoses - surgery; Dentistry; Female; Follow-Up Studies; Frontal Bone - surgery; Frontal Sinus - diagnostic imaging; Frontal Sinus - growth & development; Head and neck surgery. Maxillofacial surgery. Dental surgery. Orthodontics; Humans; Infant; Male; Medical sciences; Orbit - surgery; Osteotomy - methods; Radiography; Retrospective Studies; Sex Factors; Skull - abnormalities; Skull - surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the upper aerodigestive tract
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/S1010-5182(98)80001-2

The presence of frontal sinuses following bilateral fronto-orbital advancement is discussed controversially in the literature. In a retrospective study, 33 patients (18 male and 15 female) were operated on between 1982 and 1993, with at least one year postoperative follow-up and with a minimum age of 6 years at the end of the follow-up period following bilateral fronto-orbital remodelling, were included. The average age at which the procedure was performed was 29 months with a minimum of 3 months and a maximum of 7.8 years. The study presented shows a pneumatization of the frontal sinus in 72.7% of 33 patients following bilateral fronto-orbital advancement. The first radiographic signs of sinus development were detected between the ages of 4 and 11, average 8.3 years. There were no statistically proven correlations between frontal sinus pncumatization and age at operation or the amount of advancement of sex of the patients. Surgical enlargement of the cranium by frontal advancement with adequate stabilization results in an enlargement of the neurocranium, thereby decreasing pressure on the inner frontal cortex and allowing frontal sinus pneumatization to proceed normally. Hence, the development of a frontal sinus may be a reflection of the effectiveness of the surgical therapy.