Outcomes of treatment of fractures of the frontal sinus: review from a tertiary multispecialty craniofacial trauma service

Chegini, Soudeh; Gallighan, Niamh; McLeod, Niall; Corkill, Rufus; Bojanić, Stana; Griffiths, Stewart; Dhariwal, Daljit

doi:10.1016/j.bjoms.2016.05.016

Cited by 29 publications

(25 citation statements)

References 9 publications

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“…Management of frontal sinus fractures with CSF leak and significant posterior table displacement has historically been managed with cranialization of the sinus . Surgical techniques have recently evolved to incorporate endoscopic approaches into the treatment algorithm …”

Section: Primary Csf Rhinorrheamentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

160

279

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Background Endoscopic skull‐base surgery (ESBS) is employed in the management of diverse skull‐base pathologies. Paralleling the increased utilization of ESBS, the literature in this field has expanded rapidly. However, the rarity of these diseases, the inherent challenges of surgical studies, and the continued learning curve in ESBS have resulted in significant variability in the quality of the literature. To consolidate and critically appraise the available literature, experts in skull‐base surgery have produced the International Consensus Statement on Endoscopic Skull‐Base Surgery (ICAR:ESBS). Methods Using previously described methodology, topics spanning the breadth of ESBS were identified and assigned a literature review, evidence‐based review or evidence‐based review with recommendations format. Subsequently, each topic was written and then reviewed by skull‐base surgeons in both neurosurgery and otolaryngology. Following this iterative review process, the ICAR:ESBS document was synthesized and reviewed by all authors for consensus. Results The ICAR:ESBS document addresses the role of ESBS in primary cerebrospinal fluid (CSF) rhinorrhea, intradural tumors, benign skull‐base and orbital pathology, sinonasal malignancies, and clival lesions. Additionally, specific challenges in ESBS including endoscopic reconstruction and complication management were evaluated. Conclusion A critical review of the literature in ESBS demonstrates at least the equivalency of ESBS with alternative approaches in pathologies such as CSF rhinorrhea and pituitary adenoma as well as improved reconstructive techniques in reducing CSF leaks. Evidence‐based recommendations are limited in other pathologies and these significant knowledge gaps call upon the skull‐base community to embrace these opportunities and collaboratively address these shortcomings.

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Section: Primary Csf Rhinorrheamentioning

confidence: 99%

ICAR: endoscopic skull‐base surgery

Wang

Zanation

Gardner

et al. 2019

Int Forum Allergy Rhinol

160

279

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“…Many surgeons support conservative management for nondisplaced fractures. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Dalla Torre et al suggest that fractures with minimal bony displacement (0-2 mm) should be observed initially, whereas fractures displaced more than 5 mm will require surgery. Moderately displaced fractures (2-5 mm) are variable case to case, but some are still best treated with observation and close follow-up.…”

Section: Conservative Optionsmentioning

confidence: 99%

“…Fracture obstruction of the nasofrontal outflow tract has historically been a reason for open surgery. [9][10][11] Recent studies have challenged this idea, however; Jafari et al managed eight patients with frontal fractures obstructing the outflow tract with observation and found that seven (88%) had restored normal aeration to the frontal sinus 6 weeks after injury. 12 Whenever the normal function and flow of the frontal sinuses cannot be restored, whether identified at the time of injury or after a trial of conservative management, then open surgery with obliteration or cranialization is necessary to prevent complications of an obstructed sinus.…”

Section: Open Surgerymentioning

confidence: 99%

“…Numerous studies support cranialization when there is posterior comminution, dural tears, a persistent CSF leak, or irreversible nasofrontal outflow tract involvemen. [9][10][11]26 Classically, cranialization has been recommended for management of posterior table fractures that are comminuted, significantly displaced, or involve more than 25% of the posterior table area. 4 Today, cranialization is still employed for large and comminuted fractures, though some fractures that are displaced but have minimal comminution are amenable to reduction and fixation, with or without obliteration.…”

Section: Open Surgerymentioning

confidence: 99%

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Management of Frontal Sinus Fractures

et al. 2019

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Fractures of the frontal sinus occur from extreme forces and are often associated with other injuries. Management of frontal sinus fractures is variable and dependent on involvement of the anterior table, posterior table, and frontal outflow tract. Severe complications can developed from poorly managed fractures, such as meningitis, mucocele, mucopyocele, and brain abscess. Surgeons should be aware of appropriate management and surgical techniques for addressing frontal sinus fractures. Herein, we review the presentation and management of frontal sinus fractures, including conservative, endoscopic, and open surgical techniques.

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“…Table 4. 15 Extra cranial approach: He used a naso-orbital incision Dohlman was the firstdescribed The first extracranial approach to repair a CSF leak , Success rates with this approach range from 86% to 97%, The benefits of this approach include improved success rates with decreased morbidity and mortality (Table 4). 1 Cranialization of the frontal sinus: Was considered the treatment of choice for frontal Sinus CSF, it includes the removal of posterior wall of frontal sinu sand and all mucosa ( Table 5).…”

Section: Defect Site Preparationmentioning

confidence: 99%

Frontal sinus CSF leak: current management

Ramadan¹

2018

JOENTR

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methods to treat the pathology of the frontal sinus. The osteoplastic flap procedure was developed byBergara and Itoiz In order to improve cosmetics and surgical exposure. Donald and Bernstein introduced Cranialization of the frontal sinus to treat frontal sinus fractures. The management of frontal sinus fractures and CSF leak has changed so much due newer instrumentation and techniques of nasal endoscopy. CSF leak of frontal sinus is a rare condition that should be managed carefully; Table 1 predicts the incidence of Frontal Sinus CSF Leak among other site of nasal CSF leak. 1

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Outcomes of treatment of fractures of the frontal sinus: review from a tertiary multispecialty craniofacial trauma service

Cited by 29 publications

References 9 publications

ICAR: endoscopic skull‐base surgery

ICAR: endoscopic skull‐base surgery

Management of Frontal Sinus Fractures

Frontal sinus CSF leak: current management

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