Management of Frontal Sinus Fractures

Abstract

Frontal sinus fractures are relatively uncommon maxillofacial injuries, making up only 5 to 12 percent of all facial fractures. Associated intracranial, ophthalmologic, and other maxillofacial injuries are very common because of the force of injury required to fracture the frontal bone. High-resolution computed tomography of the frontal region in multiple planes is essential for predicting the degree of frontal injury, associated injuries, and the type of procedure indicated. Exploration of the frontal sinus with reduction alone is reserved for a small minority of very simple fractures. Most frontal sinus fractures will require the obliteration of the sinus. This is achieved in the majority of instances with preservation of the posterior wall. Those with more extensive injuries and the presence of a cerebrospinal fluid leak will require frontal sinus cranialization after repair of the dural injuries. In rare instances, primary bone grafts will be required. In both cranialization and obliteration procedures, the nasofrontal ducts must be managed appropriately to avoid complications. Newer techniques involving endoscopic image-guided surgery may offer an alternative for a small subset of patients with frontal sinus injury.

Small Supracilliary Incision for the Management of Fracture of Supraorbital Rim and Anterior Wall of Frontal Sinus

“…(11) The recent development of instrumentation and techniques for endoscopic brow-lifting has allowed access to anterior table frontal sinus fractures, without the need for a coronal incision. (7,8,11) The potential endoscopic treatment options for anterior table fractures include closed reduction without internal fixation, closed reduction with internal fixation, and fracture camouflage with bone cement. 11 or implant.…”

“…(4,5) With the development of biomedical materials and new techniques in craniofacial sinus surgery the management of frontal sinus fractures is advanced considerably. (4)(5)(6)(7)(8) We discuss a case of fracture of anterior wall of frontal sinus associated with fracture of supra-orbital rim and describe supracilliary approach through a small incision (approximately 3 cm) used for the management in this case.…”

Place and role of titanium mesh in reconstruction of the frontal bone after trauma

“…To omogućava da se odredimo prema hirurškoj tehnici, operativnom pristupu i izboru adekvatnog materijala u aktu zbrinjavanja. Različiti su pristupi u zbrinjavanju čeone kosti i čeonog sinusa: većinom je to bikoronarni pristup, rez kroz obrve i koren nosa ili korišćenje postojećih razderotina [3]. Unazad nekoliko godina stav hirurga koji se bave kraniofacijalnom hirurgijom je da je sve više zastupljen bikoronarni pristup jer omogućava bolju vizualizaciju operativnog polja i povezan je sa minimalnim postoperativnim komplikacijama, kao što su parestezije i neprihvatljivi ožiljci za pacijenta.…”

“…Kominutivni prelomi u predelu čeone kosti predstavljaju zahtevne rekonstruktivne zahvate jer sobom nose sekvele u vidu ožiljnih i koštanih deformiteta koji sobom povlače i određena psihološka stanja pacijenata nakon ozdravljenja [3,4].…”

Manejo de trauma frontal. Revisión de literatura y reporte de casos

“…La mucosa del seno colinda con las células etmoidales y el receso frontonasal y se invagina en los agujeros de Breschet (drenaje venoso y ruta de diseminación de infecciones Intracraneales, conformado por epitelio cilíndrico ciliado. Los cilios son bañados por una solución protéica o moco producido por las células caliciformes intercaladas ciliadas de la mucosa del seno frontal, y a través del movimiento de los cilios lo mueve hacia el receso y es expulsado por el hiato semilunar al canal nasal (13).…”