Can The Airleak In My Forehead Be Fixed After My Brow Bone Reduction?
Q: I need to have my brow bones/forehead contoured by you. I must let you know that I have had my brow bone shaved down 3 years ago and I have been having problems with air leakage into my forehead. I am thinking that maybe the dr. shaved down the bone a little too much. My forehead has a “flat” surface above my nose. I would like to have my forehead rounded out and possible have my eyebrow bone made a little bigger? Do you think that would fix or help the air leakage problem?
A: Brow bone reduction is about taking down the outer table of the frontal sinus. That bone is actually very thin and is not a solid block of bone as many people think. The brow bone can be reduced by burring or actually an osteotomy with plate fixation. It sounds like you had the brow bones reduced and have an area where the bone is too thin. This can happen in burring reduction by removing too much bone or in an osteotomy with plate fixation where there is an uncovered hole area. Either way, it is clear that you have a frontal sinus fistula as a result of a hole acting as a source for an air leak. This air leak should be pushing outward into the forehead tissues as it escapes from the frontal sinus which connects to the air cavities of the nose. You would do well with an hydroxyapatite cement brow bone augmentation which would build your brow out and close off the air leak as well.
Dr. Barry Eppley