• Xi Liu, Fan Zhang, Yankai Qiu, Yibo Yin, Xing Lv, Mengyu Gao, Hong Shen, and Li Liu.
• Department of Neurosurgery, the First Affiliated Hospital of Harbin Medical University, Harbin, China.
• World Neurosurg. 2024 Jun 1; 186: e125e133e125-e133.

BackgroundLarge defects of frontal sinus (FS) might be difficult to manage effectively. Mismanagement of the large defects could lead to serious postoperative complications in anterior skull base surgery. This study introduces a simple and reliable method applying small supporting bone pieces to cover or insert into large FS defects, then the large defect of FS was transformed into the small defects which was sealed by bone wax successfully.MethodsEleven patients underwent anterior skull base surgery for lesions or aneurysms, with the reconstruction of large FS defects by small supporting bone pieces. During craniotomy, mild violations of the FS mucosa were spared and sterilized, while severe violations required mucosal removal. Small supporting bone pieces were obtained from the inner plate of the bone flap and carefully covered or inserted into the large defects. The large defects were transformed into some small ones, which could be sealed effectively by bone wax. Demographic, intraoperative, and postoperative complication data were collected.ResultsFour patients had severe mucosal violations requiring removal, while 7 had mild violations sparing the mucosa. All underwent effective reconstruction with small supporting bone pieces. Median follow-up was 6 months. All cases showed effective FS morphology reconstruction, with no FS-related complications.ConclusionsApplying the small supporting bone pieces for large FS defect reconstruction can restore the FS morphology, preserve physiological function, and avoid postoperative complications.Copyright © 2024 Elsevier Inc. All rights reserved.

23 keywords...

hide…