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Utilizing Coronal Approach-Based Buccal Fat Pad for Frontonasal Duct Obliteration in Frontal Sinus Fracture
Babu Lal1, Samriddhi Burman1, Amit Agrawal2
1Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India.
Background:
Frontal sinus fractures involving the frontonasal duct require careful management to prevent complications such as mucoceles, infections, and intracranial extension. Obliteration of the frontonasal duct is essential when duct patency cannot be preserved during cranialization. This technical note presents a minimally invasive method using the buccal fat pad harvested through the temporal extension via a standard coronal approach.
Methods:
A 25-year-old male patient with a frontal sinus fracture underwent cranialization using a standard coronal approach. The temporal extension of the buccal fat pad was accessed between the temporalis and superficial temporal fascia. After complete removal of the sinus mucosa and dura repair with adjacent pericranium, the harvested fat was used to obliterate the frontonasal duct and stabilized by suturing to the pericranium.
Results:
The technique allowed effective frontonasal duct obliteration without additional incisions or donor site morbidity. It minimized surgical time, avoided alloplastic material use, and preserved facial aesthetics. The patient had an uneventful postoperative recovery.
Conclusions:
This method offers a simple, autologous, and minimally invasive alternative for frontonasal duct obliteration during frontal sinus fracture management, reducing operative complexity and potential complications.
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