Immediate reconstruction of frontal sinus fractures: review of 26 cases.
OBJECTIVE
The purpose of this study was to evaluate complications occurring after immediate reconstruction of severe frontal sinus fractures, including cases where the fracture was not limited to the anterior wall and also involved the posterior wall and/or sinus floor.


METHODS
The records of twenty-six patients presently undergoing follow-up for frontal sinus fracture reconstruction were reviewed. Information regarding demographics, fracture characteristics and causes, associated facial fractures, use of grafts or implants, type of fixation used, nasofrontal duct management, use of antibiotics, and complications were noted. Patients were asked to return for clinical and radiographic follow-up to access late complications.


RESULTS
The average age of patients with frontal fractures was 29.1 years and 92.3% were male. Mean follow-up was 3.6 years. The most common causes of fracture were motor vehicle accidents and physical aggression. All patients presented with comminuted and dislocated anterior wall fractures, 34.6% presented with posterior wall fractures, and 46% had sinus floor fractures. Complications occurred in 7 patients (26.92%) and included pneumoencephalus, frontal cutaneous fistula, frontal bone irregularity, and sinusitis.


CONCLUSIONS
Frontal sinus reconstruction is a good procedure for immediate fracture treatment if there is not excessive comminution, dislocation, or instability of the posterior wall and if the frontonasal duct area is intact or can be repaired. Most complications result from incorrect indication for reconstruction.
Gabrielli
Mario Francisco Real
MF
Oral and Maxillofacial Surgery Division, Araraquara Dental School, UNESP (Sao Paulo State University), Brazil. mfrg@foar.unesp.br
Gabrielli
Marisa Aparecida Cabrini
MA
Hochuli-Vieira
Eduardo
E
Pereira-Fillho
Valfrido Antonio
VA
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation; D002648:Child; D005147:Facial Bones / Q000293:injuries; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D018460:Fractures, Comminuted / Q000601:surgery; D005626:Frontal Sinus / Q000293:injuries*; D015522:Frontal Sinusitis / Q000209:etiology; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D012887:Skull Fractures / Q000145:classification / Q000601:surgery*