The principal cause of frontal sinus fractures is crashed car. The management depends of the complexity, because commonly there are cranioencephalic lesions associated. The surgical techniques used are the incisions, bicoronal flap or brow-glabella, infra-orbital rim ("butterfly"), associated a endoscopy sinus surgery in cases of infection, cerebrospinal fluid leak and orbital complications.

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Introduction  Vertebrobasilar insufficiency is defined as transitory ischemia of the vertebrobasilar circulation. Dizziness, vertigo, headaches, vomit, diplopia, blindness, ataxia, imbalance, and weakness in both sides of the body are the most common symptoms. Objective  To review the literature regarding the three available diagnostic testing in patients with dizziness complaints secondary to vertebrobasilar insufficiency (VBI): magnetic resonance angiography; transcranial Doppler ultrasound; and vertebrobasilar deprivation testing. Data Synthesis  We selected 28 studies that complied with our selection criteria for appraisal. The most frequent cause of the hemodynamic changes leading to VBI is atherosclerosis. The main clinical symptoms are dizziness, vertigo, headaches, vomit, diplopia, blindness, ataxia, imbalance, and weakness in both sides of the body. Even though arteriography is considered the most important exam to diagnose the disease, the inherent risks of this exam should be taken into consideration. The magnetic resonance angiography has been widely studied and is a good method to identify and localize any occlusions and stenosis in both neck and intracranial great vessels. Conclusion  Each patient with a suspected diagnosis of VBI should be individually evaluated and treated, taking in consideration the pros and cons of each diagnostic testing and treatment option.

Teachers frequently report auditory symptoms and excessive noise in classrooms, but noise level measurements are not done routinely. Study model -a prospective clinical trial. Aim -To study auditory symptoms and audiometric exams of teachers and classroom noise levels. Material and Method: Data from two groups, GI (40 teachers) and GII (40 voluntaries) were studied as follows: age, gender, working conditions, audiometric exams, and classroom noise levels. Results -In GI there were more females (86%), working in basic teaching (75%), in classes with 21-40 students (70%), with workloads between 26 and 40 hours per week (47%), and variable professional teaching time. Most teachers in GI reported excessive classroom noise (93.5%) and auditory symptoms (65%). In GI, 25% of teachers presented audiometric alterations (versus 10% of controls), with an acoustic notch predominating (11.25%; p<0.05). Noise levels close to 87dBA were recorded in classes at all teaching levels. Conclusions -occupational hearing loss may occur in teachers. Further studies are needed to confirm this proposition.