Frontal bone resorption after craniofacial reconstruction: Post-surgical complication

Complex facial fractures are still a challenge for maxillofacial surgeons around the world. This type of surgery requires the actuation of more than one specialty in the surgical center and is frequently associated with brain injuries. This article aims to present a case report of frontal bone resorption in an 18-year-old patient after neurosurgical and maxillofacial approaches involving craniotomy, use of frontal pericranium flap for treatment of anterior cranial fossa fracture, dura mater repair, cranialization, and open reduction and internal fixation. After 5 months of follow-up, the patient began to experience drainage in the right supraorbital rim. At that time, no cerebrospinal fluid was present, and the patient was referred for a second surgical approach to remove the osteosynthesis material. Frontal bone resorption is an infrequently reported complication. The frontal craniotomy combined with the frontal pericranium flap to seal the anterior cranial fossa possibly contributed to the resorption of the frontal bone. The combination of skeletal fixation and the lack of coverage of the frontal bone in the cranio-maxillofacial reconstruction sequence requires better evaluation from the vascular-periosteal point of view, since the loss of contour due to bone resorption generates a stigmatizing deformity for patients.