Current advances in sinus preservation for the management of frontal sinus fractures.
OBJECTIVE
This review summarizes the current advances in sinus preservation techniques with endoscopic sinus surgery for the well tolerated and effective management of frontal sinus fractures.


RESULTS
Advances in computed tomography (CT) imaging can now reproduce higher quality reformatted images, creating excellent diagnostic coronal, axial, and sagittal image views that provide a better evaluation of the frontal sinus outflow tracts (FSOTs). The FSOTs are pivotal in determining which technique is used in the management of frontal sinus fractures. Several recent studies have proposed sinus preservation protocols using endoscopic management of the frontal outflow tract as a viable alternative to frontal sinus obliteration. Among those protocols, extended endoscopic sinus frontal surgery with reconstruction of the frontal outflow tracts has been demonstrated to be well tolerated and effective. It can be used in conjunction with frontal sinus trephinations as well as to treat complications.


CONCLUSIONS
Modified treatment protocols have been developed based on thorough clinical examination and CT imaging in an attempt to provide a practical and safe protocol for the management of frontal sinus injuries. Conservative care and sinus preservation with or without endoscopic surgery can be done in selected cases with good result. The importance of preserving the frontal sinus is gaining acceptance in the evidence-based literature.
Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia. trimartani@yahoo.com.au
Trimartani
T
Koento
D004724:Endoscopy / Q000379:methods; D017102:Fracture Healing / Q000502:physiology; D005626:Frontal Sinus / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D019651:Plastic Surgery Procedures / Q000379:methods; D012887:Skull Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014207:Trephining / Q000379:methods