Reconstruction of post-traumatic sinus osteomyelitis.

Osteomyelitis with a fistulous tract of the left fronto-nasal area. The patient received an Anzio Beachhead WW II right fronto-nasal injury repaired with a lucite cranioplasty. A staphylococcal infection involved the remnant of the left frontal sinus with a fistula at the nasion near the orbital ridge. Bone scan revealed increased activity consistent with osteomyelitis. Patient was treated with intravenous oxacillin. The lucite skull prosthesis was removed 2 weeks after admission via the bilateral osteoplastic coronal flap approach with fat obliteration of the residual frontal sinus. The intravenous oxacillin was maintained for 48 days and the patient was discharged. The patient was later readmitted for a cranioplasty using a preformed tantalum plate. The nasal flange of the tantalum caused a deformity that did not allow the patient to wear his glasses. His third admission was for reconstruction of the tantalum and nasal deformity via a W-shaped incision.