Evaluation of the frontonasal duct in frontal sinus fractures

Heller, Elliot M.; Jacobs, Jerry A.; Holliday, Roy A.

doi:10.1002/hed.2880110109

Cited by 61 publications

(52 citation statements)

References 11 publications

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“…6 Although reconstruction of the sinus should be the aim whenever possible, 7,8 frontal sinus obliteration is used to treat fractures presenting with involvement of the posterior wall that do not require neurosurgical intervention; when damage to the drainage system occurs; in anterior wall comminutions, chronic infection and other nonmalignant conditions. 6, [9][10][11][12][13][14][15] The success of sinus obliteration is related to meticulous extirpation of the frontal sinus mucosa, internal wall decortication, permanent occlusion of the nasofrontal ducts, isolation of the grafted environment and its capacity to harbor undesired pathogens. [16][17][18][19][20][21][22][23] Abdominal fat is considered the gold standard for obliteration procedures since it was described in the 1950s 24, 25 and it has been extensively used.…”

mentioning

confidence: 99%

Frontal Sinus Obliteration with Iliac Crest Bone Grafts. Review of 8 Cases

Monnazzi

Gabrielli

Pereira-Filho

et al. 2014

Craniomaxillofacial Trauma & Reconstruction

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The medical charts of patients sequentially treated for frontal sinus fractures by obliteration with autogenous cancellous iliac crest bone in the Oral and Maxillofacial Surgery Division of this institution were reviewed. From those, eight had complete records and adequately described long-term follow-up. All were operated by the same surgical team. Those patients were recalled and independently evaluated by 2 examiners. Radiographs and/or CT scans were available for this evaluation. Associated fractures and complications were noted. The average postoperative follow-up was 7 years, ranging from 3 to 16 years. The main complication was infection. Four patients (50%) had uneventful long-term follow-ups and four (50%) experienced complications requiring reoperation. Based on the studied sample studied the authors conclude that the obliteration with autogenous bone presented a high percentage of complications in this series.

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mentioning

confidence: 99%

Frontal Sinus Obliteration with Iliac Crest Bone Grafts. Review of 8 Cases

Monnazzi

Gabrielli

Pereira-Filho

et al. 2014

Craniomaxillofacial Trauma & Reconstruction

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“…Even then, it is not uncommon for these patients to develop meningitis, fistulas, intrarrhachidian abscesses, longer hospital stay and the need for two or more surgeries 17,18,22 . Another common sequel in these cases depends on the type of injury (cribiform plate fracture) or the type of surgery, which is permanent anosmia 10,18 . Another controversial issue in the literature is the pathway used to approach the frontal sinus fracture.…”

Section: Discussionmentioning

confidence: 99%

“…In the last 15 years, in many of the frontal sinus fractures and their complications, such as CSF fistulas, injuries to the frontonasal duct, mucopyoceles and orbit complications, the nasal endoscopic techniques associated or not to the open techniques are being increasingly indicated by otorhinolaryngologists 10,15,19,23,25,26 . The latter, just as the open approach, allow the use of muscle fascia or nasal and oral mucosa free grafts, or evens the use of aloplastic material to correct dura mater defects [11][12][13]17,18,20 .…”

Section: Discussionmentioning

confidence: 99%

“…The latter, just as the open approach, allow the use of muscle fascia or nasal and oral mucosa free grafts, or evens the use of aloplastic material to correct dura mater defects [11][12][13]17,18,20 . Even today, the use of more aggressive techniques such as packing, obliteration and cranialization of the frontal sinus generate controversies 10,17,20,18,25,27 . A number of papers show different approaches, varying from conservative measures, all the way up to aggressive surgery, especially in cases of intracranial and orbit complications [11][12][13]17,19,22,23 .…”

Section: Discussionmentioning

confidence: 99%

“…As to fracture type, the most common is the frontal sinus anterior plate, although the most severe cases also involve the posterior plate and/or the sinus floor, and the naso-frontal duct may be involved [8][9][10] . In less severe injuries, the anterior plate protects the posterior, and the former is usually affected alone.…”

Section: Introductionmentioning

confidence: 99%

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Cirurgia das fraturas do seio frontal: estudo epidemiológico e análise de técnicas

Montovani¹,

Nogueira²,

Ferreira

et al. 2006

Rev. Bras. Otorrinolaringol.

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The frontal sinus trauma is not rare and it is 8% of the facial fractures. It can affect the anterior and/or posterior plates, with or without hitting the nasofrontal duct. It has a large potential of complications and its management still being a controversy. Objective: To present the casuistic of fractures frontal sinus, the epidemiology and clinical and surgical management of frontal sinus fractures. Materials and Methods: Not randomized retrospective study of 24 patients with frontal sinus fractures Hospital of Clinics, School of Medicine Botucatu, São Paulo, Brazil. Results: From the 24 patients, we had 16 (66,6%) fractures of the extern plate and 8 (33,4%) of both. In 2 patients the nasofrontal duct was involved. Others facial fractures were associated in 20 (83,4%) cases and major lesions of the cerebral segment were found in 13 (54,2%). Subpalpebral incision was performed in the majority with satisfactory aesthetic results. The basis of the surgical treatment was reduction and fixation with different materials (steel wire, mononylon, titanium miniplates) and if necessary we used alogen implants or parietal bone to reconstruct the anterior plate. Conclusion: 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 thecniques used are the incisions, bicoronal flap or browglabella, infra-orbital rim ("butterfly"), associated a endoscopy sinus surgery in cases of infection, cerobrospinal fluid leak and orbital complications.

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Frontal Sinus Fractures

Oppenheimer

Sugg

Buchman

2014

Ferraro's Fundamentals of Maxillofacial Surgery

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OverviewTreatment of the frontal sinus and its associated pathology is a controversial and highly debated topic in craniomaxillofacial trauma. A lack of consensus exists in the current literature regarding the preferred management of frontal sinus fractures, with contradictory and radically different approaches often made based solely on anecdotal evidence. Most clinical recommendations are derived from singlecenter retrospective case series with small sample sizes and selection bias. Indeed, there are striking differences between regional and international institutions pertaining to indications for treatment, timing of repair, types of operations performed, use of autogenous versus alloplastic materials, guidelines for prophylactic antibiotics, and appropriate length of follow-up. This chapter attempts to collate the available evidence into a clear and concise format in order to provide clarity to an otherwise confusing domain of fracture management. Our goal is to present a simple treatment strategy that has proven to be safe and reliable in the management of frontal sinus fractures. Anatomy and PhysiologyThe frontal sinus is located within the frontal bone deep to the supraciliary ridge. It is relatively small with an average volume of 5 cm 3 and is considered a tripartite structure consisting of a resilient anterior wall, an intervening airfi lled cavity, and a weaker posterior wall (see Fig. 19.1 ). The average height of the frontal sinus is 24.3 mm (range 5-66 mm), and its average length is 29 mm (range 17-49 mm). The anterior wall (range 2-12 mm) is substantially thicker than the posterior wall (range 0.1-4 mm) with an average thickness of 4 mm. Each sinus cavity is typically described as an inverted pyramid sitting on its point with characteristic scalloping along its borders: easily visualized on plain radiographs due to multiple incomplete septations arising from the sinus walls. The boundaries of the sinus fl oor include the orbital roof laterally and the cribriform plate medially separated for a short distance by the fovea ethmoidalis. The intersinus septum is an extension of the

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Evaluation of the frontonasal duct in frontal sinus fractures

Cited by 61 publications

References 11 publications

Frontal Sinus Obliteration with Iliac Crest Bone Grafts. Review of 8 Cases

Frontal Sinus Obliteration with Iliac Crest Bone Grafts. Review of 8 Cases

Cirurgia das fraturas do seio frontal: estudo epidemiológico e análise de técnicas

Frontal Sinus Fractures

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