J Korean Soc Plast Reconstr Surg.  2002 May;29(3):136-140.

How to Make the Blockage between the Nasal Cavity and Intracranial Space in Craniofacial Surgery

• Lee Y
• Kim WJ

Abstract

Craniofacial surgery for facial advancement or correction of severe craniofacial malformations such as orbital hypertelorism, Crouzon's disease and Apert's syndrome may bring about great risk. Especially postoperative infection in the craniofacial surgery is a life threatening complication. Ascending infection via nasofrontal communication in frontofacial monobloc advancement, intracranial Le Fort III osteotomy, correction of hypertelorism(intracranial approach) and acute trauma of cribriform plate can lead to life threatening meningitis and meningoencephalitis. A 4 layer sealing technique for the closure of nasofrontal communication using Gelfoam , the inferiorly based, galeo-pericranial flap, rib bone graft, Tissel is a very effective method. Until the rib bone graft is completely uptaken, Gelfoam is used as a temporary blockage of bony defect and prevents displacement of rib bone graft. We used galeo-periosteal flap for the sufficient blood supply to the rib bone graft. And Tissel is used as a biologic adhesive and blockage of the surrounding gaps.

Keyword

Craniofacial surgery; Nasofrontal communication; Ascending infection

MeSH Terms

Adhesives
Craniofacial Dysostosis
Ethmoid Bone
Fibrin Tissue Adhesive
Gelatin Sponge, Absorbable
Hypertelorism
Meningitis
Meningoencephalitis
Nasal Cavity*
Orbit
Osteotomy
Ribs
Transplants
Adhesives
Fibrin Tissue Adhesive