Usefulness of vascularized galeal frontalis myofascial flap as treatment for postoperative infection in frontal sinus fracture

Inappropriate treatments of frontal sinus fractures may lead to serious complications, such as mucopyocele, meningitis, and brain abscess. Assessment of nasofrontal duct injury is crucial, and nasofrontal duct injury necessitates sinus obliteration. For sinus obliteration, autogenous fat, muscle, bone, pericranium grafts, and alloplastic materials, such as Surgicel, hydroxyapatite (Bone Source), and methyl methacrylate, are commonly used. However, autogenous tissue grafts and alloplastic materials cannot prevent infection, which is the leading cause of complications of frontal sinus surgery. A good vascular supply is the mainstay of resistance against infection. A 21-year-old man had nasofrontal duct injury and frontal sinus fracture by motorcycle accident. He underwent cranialization and frontal sinus obliteration with autologous bone graft and hydroxyapatite. On 16 days postoperatively, the patient had a high temperature with wound infection in the glabella. Thus, he was treated with sinus obliteration with vascularized galeal frontalis myofascial flap. He was followed up postoperatively for 1 year without infection. The authors experienced a postoperative infection in frontal sinus fracture, which was treated with vascularized galeal frontalis myofascial flap and achieved satisfactory result; thus, we presented our case with reviews of the literature.