Kudryk W H, Mahasin Z
Division of Otolaryngology, University of Alberta, Edmonton, Alberta, Canada.
J Otolaryngol. 1988 Dec;17(7):395-7.
The osteoplastic flap is a widely used technique as an approach to frontal sinus disease. All current textbooks describe the technique with basing the flap inferiorly along the orbital rim and across the naso-frontal suture line. Since 1977, we have had occasion to base the flap superiorly in eight cases with good results. We feel that the superiorly based flap is ideally indicated in unilateral disease, particularly in the balding male, where a coronal incision would be very obvious. It is also a more direct approach. The skin incision itself can be parallel to the brow or almost identical to a blepharoplasty incision. After the floor of the frontal sinus has been removed (as in a Lynch or Howarth approach), cuts in the anterior wall of the frontal sinus are made under direct vision, and the bone is fractured at the superior extent of the sinus. This is certainly quicker and simpler than the standard approach, where a template is required. The risks of CSF leak are greatly diminished. The surgeon has the option of obliterating the sinus, removing the intersinus septum, or creating a mucoperiosteal flap. Details of the technique and two illustrative cases are presented.
骨成形瓣作为一种治疗额窦疾病的方法，是一种广泛应用的技术。目前所有的教科书都描述该技术是将骨瓣沿眶缘下方并跨过鼻额缝线进行基底固定。自1977年以来，我们有机会在8例患者中采用骨瓣上方基底固定法，效果良好。我们认为，上方基底固定的骨瓣在单侧疾病中是理想的选择，特别是在男性秃发患者中，冠状切口会非常明显。这也是一种更直接的方法。皮肤切口本身可以与眉毛平行，或几乎与眼睑成形术切口相同。在切除额窦底部（如Lynch或Howarth手术）后，在直视下在额窦前壁进行切口，并在窦的上缘处折断骨头。这肯定比需要模板的标准方法更快、更简单。脑脊液漏的风险大大降低。外科医生可以选择闭塞窦腔、切除窦间隔或制作黏膜骨膜瓣。本文介绍了该技术的细节和两个说明性病例。
