Frontal sinus ablation by cranialization. Report of 21 cases

Twenty-one patients who had a cranialization of the frontal sinus following massive penetrating wounds were reviewed; 75% had injuries to other areas, 50% were admitted in shock, 42% were comatose, and 25% had a tracheostomy. Death ensued within two weeks of surgery in 25%. Postoperatively, four patients had a CSF leak from elsewhere in the cranial floor, but no patients suffered from meningitis or brain abscess. All leaks stopped spontaneously. One patient had a small wound abscess and in another a subcutaneous aerocele formed. The remaining patients healed uneventfully. Of the patients followed up, none suffered delayed complications. No subsequent deformity over the frontal sinus eventuated except in one patient whose cosmetic defect was minor. The cranialization operation is considered by us to be a safe and effective procedure.