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Treatment of the Severely Infected Frontal Sinus With Latissimus Dorsi Myocutaneous Free Flaps

Title
Treatment of the Severely Infected Frontal Sinus With Latissimus Dorsi Myocutaneous Free Flaps
Author
이형중
Keywords
Frontal sinus fracture; cranioplasty; nasofrontal duct; latissimus dorsi; free flap
Issue Date
2011-06
Publisher
Lippincott, Williams and Wilkins
Citation
The Journal of craniofacial surgery,Vol.22, No.3 [2011],962-966
Abstract
In trauma patients with severe intracranial hemorrhaging, diagnosing facial bone fractures can be delayed. In frontal sinus fractures with nasofrontal duct obstruction, obliteration of the nasofrontal duct and the sinus is the current treatment of choice. But with inadequate management, ascending infections happen, and widely spread infections can involve the entire frontal soft tissues, which result in meningitis, encephalitis, and subcutaneous abscess pockets creating skin defects. In the treatment of these infections, radical debridement of all infected tissues including galea, pericranium, and surrounding soft tissues is obligatory; hence, available local vascularized flap options for obliteration of the postdebridement defect are scarce. In these situations, free-tissue transfer can be a treatment option. Although there have been numerous reports of using nonvascularized materials for obliteration of the frontal sinus, the material itself can serve as a nidus for infection, and it is generally accepted that well-vascularized tissues have greater ability to withstand local soft-tissue infection and osteomyelitis. Hence, we report 3 cases where we performed latissimus dorsi myocutaneous flaps for severe frontal sinus infections after frontal cranioplasty for severe hemorrhaging. Large bulks of muscle obliterated the nasofrontal duct and the dead space surrounding the entire frontal sinus. The latissimus dorsi myocutaneous flap is not a permanent solution for frontal sinus reconstruction, which requires a secondary bony reconstruction. However, when we face acute stages of intractable infections of the frontal sinus, it can control the infection and result in saving the patient's life.
URI
https://insights.ovid.com/crossref?an=00001665-201105000-00045
ISSN
1049-2275
DOI
10.1097/SCS.0b013e31820fe2d8
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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