Unilateral Cranialization as an Approach for Posterior Table Frontal Sinus Fractures

Management of posterior table fractures has seen a conservative shift in recent years. Patients who present with CSF leak may be safely monitored, while cranialization is reserved for patients with severe comminuted or displaced posterior table fractures. We report the case of a 20-year-old patient with a comminuted, displaced posterior table fracture that was missing a central segment and was associated with dural injury. The septum and contralateral sinus were unaffected, thus warranting unilateral cranialization. This is a reported case of hemicranialization, which falls on the spectrum of a conservative approach. At 12 months post-op, the patient has not experienced any complications historically associated with cranialization including persistent CSF leak, meningitis, wound infection, alopecia or facial nerve injury at the site of surgery.