[Osteoplastic frontal sinus flap. Study of 47 cases].

Osteoplastic flap of the frontal sinus, described by Macbeth over 40 years ago, still is the best surgical approach for the diagnosis and definitive treatment of chronic disease. Forty-seven patients were treated with this technique between 1978 and 1995. The conditions treated were, by order of frequency: 16 fronto-ethmoidal mucocele, 12 osteoma, 12 hypertrophic sinusitis, and less frequent disorders, such as osteomyelitis (2), fibrous histiocytoma (2), tuberculosis (1), frontal fracture (1) and dilated pneumosinus (1). The surgical approach was coronal in 28 patients, brow in 18 and hemicoronal in 3. In some cases, other approaches were associated: 13 lateral rhinotomy, 6 sublabial and 1 intranasal. Nasofrontal duct obstruction was found in 89% of cases and erosion of one or more sinus walls in 70%. Intraoperative complications included 4 small dural tears, 1 with leakage of cerebrospinal fluid. Postoperative complications included 4 frontal deformity, 2 persistent frontal anesthesia, 1 supraorbital nerve neuralgia, 1 post-anticoagulant epistaxis and 1 death from pulmonary embolism.