The commitment of the frontal sinus with involvement of its walls is a rare lesion, around 5-12 % of all facial fractures. It's usually associated with intracranial, ophthalmologic, maxillofacial fractures and other injuries, and when there is a fracture of the posterior wall, requires immediate treatment with frontal sinus obliteration due to communication with meninges and frontal lobe because of infectious risk. We treat 18 patients with craniofacial trauma and fractures of the frontal sinus with involvement of the posterior wall in the period between 2007 and 2011, 8 women and 10 men, aged between 15 and 64 years. All cases were treated with open reduction and internal fixation using different appoaches and using adjacent pedicle flaps. The vitality of the flaps was 100%. We certify the correct positioning by computed tomography. The treatment of the fractures of the frontal sinus with involvement of the posterior wall or of the nasofrontal duct require obliteration with vascularized tissue to prevent communication with the nasal cavity.
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