Osteoplastic Flaps With and Without Obliteration

Although minimally invasive endoscopic frontal sinus surgery has become the mainstay of managing both chronic and in many cases neoplastic disease of the frontal sinus, open approaches to the frontal sinus remain viable options for managing many diseases in the frontal sinus. Once considered the gold standard for managing frontal sinusitis, the osteoplastic flap with and without obliteration is a useful approach and surgical treatment of recalcitrant chronic frontal rhinosinusitis that has failed—or is not amenable—to endoscopic management as well as many benign or malignant frontal sinus tumors and frontal sinus trauma. Because it has fallen out of the mainstay of surgical management, performing an osteoplastic flap with or without obliteration requires a considerable knowledge of the anatomy of the scalp, its neurovascular architecture, and osteology of the frontal bone. Once fully understood, the osteoplastic approach can remain in the armamentarium of the otolaryngologist for the successful treatment of a wide array of ailments affecting the frontal sinus.