Management of frontal sinus fractures.
OBJECTIVE
After studying this article, the participant should be able to: 1. Understand the radiographic and clinical diagnosis of frontal sinus fractures. 2. Identify various management approaches to the frontal sinus fracture and the indications for each. 3. Understand the rationale behind the decision of sinus obliteration when needed. 4. Recognize the most common complications arising from frontal sinus fracture treatment and the methods of avoiding or managing these complications.


CONCLUSIONS
Frontal sinus fracture management is still controversial and involves preserving function when feasible or obliterating the sinus and duct, depending on the fracture pattern. There is no single algorithm for the choice of management, but appropriate treatment depends on an accurate diagnosis using physical examination, computed tomography data, and the findings of intraoperative exploration. The amount and location of fixation and the need for frontonasal duct and sinus obliteration or elimination of the entire sinus depend on the anatomy of the fracture in general and the extent of involvement of the anterior wall of the sinus, the frontonasal duct, and the posterior wall in particular. This article discusses an algorithm for frontal sinus fractures that was obtained from the literature and modified according to the authors' experience. The decision-making process presented by the authors has withstood the test of time over a period of more than 20 years in their practice and has been proven to be safe and efficacious in treating frontal sinus fractures of all types.
Yavuzer
Reha
R
Department of Plastic, Reconstructive, and Aesthetic Surgery, Gazi University Medical Faculty, Ankara, Turkey. ryavuzer@hotmail.com
Sari
Alper
A
Kelly
Christopher P
CP
Tuncer
Serhan
S
Latifoglu
Osman
O
Celebi
M Cemalettin
MC
Jackson
Ian T
IT
D000063:Accidents, Traffic; D000273:Adipose Tissue / Q000637:transplantation; D000465:Algorithms; D001860:Bone Plates; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D005626:Frontal Sinus / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000293:injuries*; D006801:Humans; D012887:Skull Fractures / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D013524:Surgical Flaps; D014057:Tomography, X-Ray Computed
D015718:Fibrin Tissue Adhesive