Endoscopic repair of isolated anterior table frontal sinus fractures.
BACKGROUND
Recently developed endoscopic brow-lifting techniques and instrumentation are being used for treatment of anterior table frontal sinus fractures. Potential endoscopic treatment options include fracture reduction with or without plating and fracture repair with hydroxyapatite bone cement (HA).


OBJECTIVE
To evaluate the efficacy of miniplates and HA for repair of anterior table fractures.


METHODS
Frontal sinus fractures were generated in 11 cadavers. Standard endoscopic brow-lifting techniques were used to visualize the fracture from above. A 1-cm Lynch incision was used to apply instrumentation from below. Fractures were repaired with either miniplate reduction or HA recontouring.


RESULTS
All fractures were exposed without difficulty. Miniplates were applied in 5 specimens: 1 specimen had a complete reduction, 2 specimens had partial reductions, and 2 specimens had incomplete reductions. Bone cement was applied in 9 specimens: 4 specimens were rated as excellent and 5 specimens as good.


CONCLUSIONS
Frontal sinus fractures can be successfully exposed and repaired with an endoscopic technique. Endoscopic miniplate reduction of frontal sinus fractures can be accomplished. However, it is challenging, and success rates vary depending on fracture comminution. Endoscopic HA recontouring offered the best results, with good or excellent outcomes in all specimens.
Strong
E Bradley
EB
Department of Otolaryngology, University of California, Davis, School of Medicine, Sacramento 95817, USA.
Buchalter
Gregory M
GM
Moulthrop
Thomas H M
TH
D001843:Bone Cements; D001860:Bone Plates; D002102:Cadaver; D005593:Fracture Fixation, Internal / Q000379:methods*; D005626:Frontal Sinus / Q000601:surgery*; D006801:Humans; D012887:Skull Fractures / Q000601:surgery*; D016896:Treatment Outcome; D020535:Video-Assisted Surgery
D001843:Bone Cements