اعوجاج الحاجز الانفي وتضخم غضاريف ‏الانف

Male patient admitted  to the hospital by fever, headache, malaise and diplopia.
Physical examination shows left eye proptosis, oedema and ecchymosis. Frontal area shows also redness, edema and tenderness.
Previous  history of ophthalmological intervention.
Investigation done by CT maxillofacial axial and coronal which revealed left frontal sinusitis and ethmoiditis and frontal outer table erosion and soft tissue thickness in the frontal area.
Diagnosis is most propaply frontal osteomyelitis due to chronic frontal sinusitis.
Then patient prepared for surgical drainage after taking aggressive antibiotic course.
We did also plain X-RAY Caldwell luc view to make a frontal template to outline the boundries of the frontal sinus.
The operation done was frontal osteoplastic flap. The approach was through bicoronal incision and elevation of scalp above the plane of pericranium to the level of supraorbital and supratrochlear then under the pericranium to avoid injury of vessel. Until we reach the supraorbital margin then we open the frontal sinus by osteotome and hummer and clear the frontal sinus and its outflow tract. We did also endoscopic sinus surgery through the nose to clear the ethmoid sinus. Then we closed the incision.