Frontal Sinus Fractures

Abstract

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.

Frontal Sinus Fractures: A Review on Etiology and Management Emphasizing Minimally Invasive and Endoscopic Techniques

“…31 Restoration of the frontal sinus outflow is imperative to the normalization of proper sinus function and this can be achieved through conservative endoscopic techniques. 32 One study reported that proper treatment plans designed to preserve frontal sinus tract outflow in cases of CSF rhinorrhea with minimal acute and long-term complications showed a success rate of 90% in the first endoscopic attempt at repair. 33 However, there is a limitation to endoscopic approaches that needs to be considered.…”

“…Endoscopic approach can also be used for treating CSF rhinorrhea, even in the case of previous craniotomy or neurosurgical procedures 31 . Restoration of the frontal sinus outflow is imperative to the normalization of proper sinus function and this can be achieved through conservative endoscopic techniques 32 . One study reported that proper treatment plans designed to preserve frontal sinus tract outflow in cases of CSF rhinorrhea with minimal acute and long-term complications showed a success rate of 90% in the first endoscopic attempt at repair 33 …”

Frontal Sinus Fractures: An Evaluation of Patient Demographics, Mechanisms of Injury, Classification, and Management Strategies in Patients Referred to a Trauma Center, From 2014 to 2019

“…Today, the general trend has shifted from radical ablative procedures in the past to more conservative approaches to achieve the esthetics of the anterior frontal wall and preserve sinus function. 7,[16][17][18][19][20][21] However, the selection of an optimal strategy still depends on the pattern of the fracture and the associated complications, and it is also influenced by the professional experience of the surgeon. 2,6,9,22 The purpose of this retrospective study was to present the demographic data, mechanism of injury, classification of fracture, and management strategies in patients with frontal sinus fractures who attended the Oral and Maxillofacial Surgery Department at Rajaee Hospital of Shiraz, Iran.…”

Reconstructive Management of Gunshot Wounds to the Frontal Sinus

“…Frontal sinus injury is common in trauma patients and accounts for up to 15% of all facial fractures 1 . The frontal sinuses are 1 set of paired sinuses that, in conjunction with the frontal sinus recess, are essential for draining and clearing mucus.…”

“…F rontal sinus injury is common in trauma patients and accounts for up to 15% of all facial fractures. 1 The frontal sinuses are 1 set of paired sinuses that, in conjunction with the frontal sinus recess, are essential for draining and clearing mucus. The anatomy of this region is composed of the following: (1) a thicker anterior table that provides contour, (2) a sinus floor that overlies the orbital region, and (3) a posterior table that overlies the anterior cranial fossa (Fig.…”