Pneumosinus dilatans: Rare cause of slowly changing fron tal contours

Abstract

Frontal pneum osinus dilatans is a rare entity that is docu mented only by a few reports. It is an abnormal expansion of the aerated frontal sin us, with sinus walls of normal thickness. The expansion of the bone may be generalized or focal. It is not only an aesthetic problem but may also have function al consequences. We herein present the case of a 23-year-old woman who had been referred to the maxillofacial and plastic unit in Sou sse (Tunisia) comp laining of a prominence on her right supraorbital region and foreh ead. The cause was unknown and there were no functional problems. Comput ed tomography showed a large pne umatized frontal sinu s and confi rmed the resulting bony prominence. The patient was ta ken to the operating room, where the frontal and supraorbital regions were exposed throug h a bicoronal incision. The ante rior wall of the right frontal sinus was removed, and was divided into segments that were then fi xed in the desired position using a titanium mes h plate. Excellent results were obtained, and the patient had no complaints and was satisfi ed with her appea ranc e. She remained well two years postoperatively. Pneumosinus dilatans is an entity every plastic surgeon should be aware of because its treatment falls within the realm of craniofacial surgery. The etiol ogy remains unclear, and surgica l management is directe d toward surgical exploration of the sinu s to ensure recontou ring of the anterior table of the frontal sinus to correct any cosm etic deformity. Several authors have published different surgical techniques.