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Scientific Oral Presentations

Facial Plastic and Reconstructive Surgery

Session: Scientific Oral Presentation 1 - Facial Plastics and Reconstructive Surgery

Radiologic Evidence of Delayed Frontal Sinus Disease After Feminizing Frontal Cranioplasty: A Pilot Study

Sunday, October 12, 2025

1:24 PM - 1:30 PM EDT

Location: 137

Disclosure(s):

Ketan Jain-Poster, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Feminizing frontal cranioplasty (FFC) has emerged as an essential technique in feminization of the upper third, often involving the violation of the anterior table of the frontal sinus. Though case reports document serious frontal sinus complications years after external approaches involving the frontal sinus, no studies to date examine the objective presence of frontal sinus disease on long-term imaging surveillance after FFC.

Methods: Adult patients who underwent FFC with type III forehead classification between the months of August 2016 to December 2019 at a single integrated healthcare system were invited to complete computerized tomography (CT) scans after surgery. Preoperative and postoperative CT were compared using the Lund-Mackay (LM) scoring system and assessed for the presence of frontal sinus disease. Retrospective chart review for demographic data and new diagnoses of sinusitis were extracted for included patients.

Results: A total of 36 patients met inclusion criteria. The average time from surgery to postoperative CT scan was 71.7 months (median: 69 months; range: 57 to 96 months). The mean preoperative and postoperative total LM scores were 1.19 and 1.11 (p=0.99), respectively. The mean frontal sinus-specific preoperative and postoperative LM scores were 0.08 and 0.08 (p=0.80), respectively. Three patients exhibited frontal sinus mucosal thickening on postoperative CT scans, and significant frontal sinus pathology (e.g. mucoceles) were not found in any patients.

Conclusions: Feminizing frontal cranioplasty appears to be a relatively safe procedure with low risk for the development of frontal sinus-related complications within the first 6 years after surgery. Continued surveillance follow-up and imaging should be considered to detect serious frontal sinus pathology that may develop beyond this timeframe.

Presenting Author(s)

KJ

Ketan Jain-Poster, MD

Resident Physician
Kaiser Permanente Med Group - Northern California
Oakland, CA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

VA

Vivek S. Annadata, BS

Medical Student
Hofstra/Northwell School of Medicine
Uniondale, NY, United States

Disclosure information not submitted.
CS

Charles W. Shih, MD

Senior Physician
Kaiser Permanente Med Group - Northern California
Oakland, CA, United States

Disclosure information not submitted.
KB

Kathleyn A. Brandstetter, MD

Physician
Kaiser Permanente Med Group - Northern California
San Francisco, CA, United States

Disclosure information not submitted.
AK

Andrew Kleinberger, MD

Kaiser Permanente Med Group - Northern California, United States

Disclosure information not submitted.

Senior Author(s)

JL

Jonathan Liang, MD

Associate Professor
Kaiser Permanente
Oakland, CA, United States

Disclosure information not submitted.