Resident Manual of Trauma to the Face, Head and Neck

CHAPTER 3: Upper Facial Trauma

The frontonasal duct is eliminated by inverting the frontal sinus mucosa left in the funnel-shaped entrance to the duct upon itself, and then obliterating the duct with a block of temporalis muscle (Figure 3.8). The cleansed anterior wall fragments are similarly divested of all their mucosa with a cutting bur, and then fixed in place with square plates and miniplates (Figure 3.9). The scalp is closed and a light-pressure dressing is applied.

Figure 3.8 Cranialization procedure—The mucosa of the sinus is removed from the sinus lumen, the frontonasal duct mucosa is inverted on itself, and the frontonasal ducts are plugged with temporalis muscle.

Figure 3.9 Cranialization procedure—Craniotomy returned with wire and fragments of the frontal sinus fixed with plates.

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Resident Manual of Trauma to the Face, Head, and Neck