Survey of Current Practice Patterns in the Management of Frontal Sinus Fractures

Abstract

The management of frontal sinus fractures has evolved in the endoscopic era. The development of functional endoscopic sinus surgery (FESS) has been incorporated into management algorithms proposed by otolaryngologists, but the extent of its influence on plastic surgeons and oral and maxillofacial surgeons is heretofore unknown. A cross-sectional survey was performed to assess the practice pattern variations in frontal sinus fracture management across multiple surgical disciplines. A total of 298 surveys were reviewed. 33.5% were facial plastic surgeons with otolaryngology training, 25.8% general otolaryngologists, 25.5% plastic surgeons, and 15.1% oral and maxillofacial surgeons. 74.8% of respondents practiced in an academic setting. 61.7% felt endoscopic sinus surgery changed their management of frontal sinus fractures. 91.8% of respondents favored observation for uncomplicated, nondisplaced frontal sinus outflow tract fractures. 36.4% favored observation and 35.9% favored endoscopic sinus surgery for uncomplicated, displaced frontal sinus outflow tract fractures. For complicated, displaced frontal sinus outflow tract fractures, obliteration was more frequently favored by plastic surgeons and oral and maxillofacial surgeons than those with otolaryngology training. The utility of FESS in managing frontal sinus fractures appears to be recognized across multiple surgical disciplines.

Evaluating contemporary pain management practices in thyroid and parathyroid surgery: A national survey of head and neck endocrine surgeons

“…This national survey study is one of the first to objectively assess and describe the contemporary pain management strategies and opioid prescribing practices among head and neck endocrine surgeons. Furthermore, we observed relatively high survey response (34%) and completion (100%) rates compared to RR of 7.7%‐24% reported in other recently published Otolaryngology‐specific surveys, and this is a major strength of the present study. The results reveal that a majority of surgeons utilize postoperative opioids and that the associated prescribing practices vary substantially.…”

Traumatic Frontal Sinus Fractures Management: Experience from High-Trauma Centre

“… 29) FSF are common shared area of interest between neurosurgeons, plastic surgeons, otolaryngologists and maxillofacial surgeons. 8 17 37) Naso-frontal outflow tract (NFOT) obstruction can change the algorithm of treatment. 49) The treatment indications of our institution is based on the fracture type, posterior table integrity, NFOT, head trauma severity, CSF leakage and neurological status.…”

Frontal Sinus Fractures: Evolving Clinical Considerations and Surgical Approaches

“…FSOT involving injuries are managed across multiple surgical specialties with backgrounds in oral and maxillofacial surgery, otolaryngology, and plastic surgery, each with unique training backgrounds. In a 2016 cross-sectional survey across these specialties, plastic and oral and maxillofacial surgeons were more likely to perform obliteration of anterior fractures requiring repair with a concomitant injury to the FSOT 69. Those with a background in otolaryngology, on the other hand, favored ORIF 69.…”

“…In a 2016 cross-sectional survey across these specialties, plastic and oral and maxillofacial surgeons were more likely to perform obliteration of anterior fractures requiring repair with a concomitant injury to the FSOT 69. Those with a background in otolaryngology, on the other hand, favored ORIF 69. Yet all specialties favored observation or FESS for FSOT injuries 69.…”

“…69 Those with a background in otolaryngology, on the other hand, favored ORIF. 69 Yet all specialties favored observation or FESS for FSOT injuries. 69 These changing management strategies appear to impact all specialties, demonstrating the familiarity required in both endoscopic and open techniques.…”