Computed Tomography Image Guidance for More Accurate Repair of Anterior Table Frontal Sinus Fractures

The frontal bone serves a protective role, representing the transition between the facial skeleton and the cranium. Within its enclosure, the frontal sinus lies adjacent to many important intracranial structures, and injury to this region has severe complications if not properly managed. Historically, the goals of frontal sinus fracture management have been to best prevent intracranial complications with invasive procedures, but a recent shift favoring conservative management now aims to preserve the form and function of the frontal sinus and its outflow tract. With the advancement of endoscopic techniques and the development of new technologies, many alternatives to aggressive surgical management are available.

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“…2,5,8 Computed tomography image guidance may offer increased precision in extracranial repairs of the anterior table. 23…”

Section: Surgical Techniquesmentioning

confidence: 99%

Frontal Sinus Fractures

Schultz

Braun

Truong

2017

Seminars in Plastic Surgery

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“…The importance of the presence or absence of naso-frontal channel and its condition in the trauma and after surgery is especially emphasized in prognostics. Rodriguez et al [12] suggest a certain algorithm procedures in the treatment of the injury sinus, which is backed up by a comprehensive series of patients, and is based on the fact that the decision about treatment should derive from a variety of factors to consider: the type of fracture, the extent of damage to the back wall of sinus and naso-frontal channel, the neurological status of the patient and the presence of associated trauma and existence of nasal liquorrhea [1316].…”

mentioning

confidence: 99%

Proptosis and Diplopia as Consequences in Trauma of Craniofacial Junction

Pajić¹,

Boljevic

Antic

et al. 2017

FU Med Biol

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Abstract. In the trauma of craniofacial junction, frontal sinus wall fractures take up 5-15% of all facial bone fractures. The most common mechanism of their occurrence comes as a result of the action of high-energy impact force on the frontal area. Treatment of the injuries in frontal-orbital-ethmoidal regions largely depends on the responsible experts (otolaryngologist, maxillofacial surgeon or neurosurgeon) in all cases, because of the implementation of diverse surgical technics in order to achieve the best possible outcome for the patient. Bearing in mind the complex anatomical features of this region, it is clear that these procedures are often accompanied by series of possible complications, all of which are certainly neurosurgical. These can be expressed as early or late complications, and could be characterized by diverse clinical manifestations. Mucocele is formed, either due to partial obstruction of the sinus mucosa or due to the obstruction of the frontal sinus. The long term existence of mucocele and its progressive growth will result in strongpressure on the adjacent bones, and lead to their destruction followed by the process-propagation into surrounding tissues and spaces. In the further development if a bacterial contamination is detected, it will lead to the purulent inflammatory process and clinical picture of mucopyocele. In most clinical cases with complications proptosis and diplopia are dominant ophthalmic manifestations. In this paper we will present our experience in the treatment of proptosis and diplopia, as well as the ways of diagnostic evaluation in order to achieve timely diagnosis and assure swift healing of patients.

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