State of the art in craniomaxillofacial trauma: frontal sinus.
OBJECTIVE
Many of the successes and controversies in endoscopic management of craniofacial trauma are exemplified in the management of frontal sinus trauma.


RESULTS
The effort to reduce surgical morbidity and to optimize reconstruction of craniomaxillofacial injuries has resulted in the development of less invasive surgical approaches and in the use of computer image guidance in surgical planning and execution. Minimally invasive management of frontal sinus inflammatory disease has gained wide acceptance. The technology and techniques applied to surgery of the floor of the frontal sinus is now being applied to the management of frontal sinus trauma. A paradigm shift in the treatment of frontal sinus trauma may be underway.


CONCLUSIONS
An increasing scope of less severe injuries is being managed expectantly with endoscopic frontal sinus surgery available for salvage. There may be an overall decrease in the most severe frontal sinus injuries owing to enforcement of seatbelt and airbag usage. And the most severe injuries are often best managed through cranialization with anterior skull base reconstruction. Thus, the role for frontal sinus obliteration purely to obviate fractures of the frontal sinus outflow tract may be vanishing.
Rontal
Matthew L
ML
St John's Providence Hospital, Southfield, Michigan, USA.
D000063:Accidents, Traffic; D004724:Endoscopy / Q000379:methods*; D005151:Facial Injuries / Q000601:surgery; D018460:Fractures, Comminuted / Q000601:surgery; D005626:Frontal Sinus / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008335:Mandibular Condyle / Q000293:injuries / Q000601:surgery; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009078:Mucocele / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000379:methods*; D019291:Skull Base / Q000601:surgery; D012887:Skull Fractures / Q000209:etiology / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000379:methods