Pneumosinus Dilatans: Rare Cause of Slowly Changing Frontal Contours

Friday, April 12, 2013
Jed Bouguila, Monia Omezzine, Samiya Ayachi, Zouha Mziou, Radouane Mani, Abelfattah Slama, Ramzi Moatamri and Habib Khochtali, Maxillofacial and Plastic surgery, Sahloul Hospital, Sousse, Tunisia
Goals/Purpose:

Frontal Pneumosinus dilatans is a rare entity and documented only by few reports. It is an abnormal expansion of the aerated frontal sinus, with sinus walls of normal thickness. The expansion of the bone may be generalized or focal.

The expansion of the pneumosinus is not only an aesthetic problem but may also have functional consequences.

Methods/Technique:

A 23-year-old woman was referred to the maxillofacial and plastic unit in Sousse (Tunisia) complaining of prominence of her right supraorbital region and forehead. The cause was unknown and there were no functional problems. Computed tomography showed a large pneumatised frontal sinus and confirmed the resulting bony prominence.

The patient was taken to the operating room, where the frontal and supraorbital region was exposed through a bicoronal incision. The anterior wall of the right frontal sinus was removed, and divided into segments which are then fixed in the desired position using titanium mesh plate.

Results/Complications:

Excellent result were obtained, the patient had no complaints and were satisfied with her appearance. She remained well tow years postoperatively.

Conclusion:

Pneumosinus dilatans is an entity every plastic surgeon should be aware of, because its treatment falls within the realm of craniofacial surgery. The etiology remains unclear. Surgical management is directed toward surgical exploration of the sinus to ensure recontouring of the anterior table of the frontal sinus to correct any cosmetic deformity. Several authors have published different surgical techniques.