Craniofacial trauma often causes cranial defects over the midline and is often accompanied by frontal sinus injury and frontal sinusitis, which makes treatment difficult because the sagittal sinus also passes through the midline, and patients often need multiple surgeries. While repairing the skull defect, frontal sinus injury must be properly treated to avoid the spread of frontal sinusitis into the skull, causing intracranial infection and serious complications. For the order of cranial defect repair and residual frontal sinus treatment, most patients have good postoperative results when the mucosa of the residual frontal sinus is treated while the cranial defect is repaired. In individual patients, if frontal sinusitis recurs, frontal sinus nasal anastomosis is performed and the titanium prosthesis is removed at the same time. Some patients need to deal with frontal sinusitis first, and after the operation, we ask the ear, nose and throat consultation to confirm the patency of the frontal nasal canal, and repair the cranial defect in the second stage with good recovery. Therefore, we believe that if there is no obvious infection or mild infection in the residual frontal sinus, the frontal sinus can be treated and the cranial defect can be repaired at the same time. If the infection is serious, it is necessary to deal with frontal sinusitis first and ask ENT to check the patency of the frontal nasal duct after surgery. If it is not, it is necessary to do transnasal endoscopy to make the frontal nasal duct patency before repairing the cranial defect.