Abstract:

Objective

To investigate the management strategies for intraoperative frontal sinus opening during craniotomy and the diagnosis/treatment of postoperative secondary local infections.

Methods

A retrospective analysis was performed on 11 patients with a history of frontal sinus manipulation during prior craniotomy，who developed local infections secondary to frontal sinusitis and underwent surgical treatment at Neurosurgery Department of The First Affiliated Hospital of Xinjiang Medical University from July 2020 to January 2024. All patients underwent a combined surgical protocol：local craniotomy debridement，pedicled temporal muscle flap packing into the frontal sinus，and endoscopic transnasal frontal sinusotomy. Postoperative incidence rates of intracranial infection and cerebrospinal fluid leakage were documented. One month after surgery，cranial imaging examinations and nasal endoscopy were performed to evaluate the condition of the frontal sinus opening. Long-term outcomes were monitored for 6-42 months to evaluate frontal sinusitis recurrence.

Results

All 11 patients achieved successful wound healing with no instances of cerebrospinal fluid leakage or intracranial infection. One-month postoperative imaging confirmed complete resolution of local inflammation，while nasal endoscopy demonstrated patent frontal sinus ostia during the follow-up period，none of the patients exhibited recurrence of frontal sinusitis.

Conclusion

The standardized treatment of the frontal sinus during craniotomy surgery is a prerequisite for avoiding the occurrence of frontal sinusitis. “local craniotomy debridement+pedicled temporal muscle flap packing into the frontal sinus+endoscopic transnasal frontal sinusotomy” is an effective method for treating secondary local infections in frontal sinusitis.

Key words: Frontal sinus, Frontal sinusitis, Infection, Craniotomy surgery