title: Management of frontal sinus fractures--treatment decision based on metric dislocation extent.
abstract: The treatment of frontal sinus fractures is still a matter of research in neurosurgical and craniofacial surgery. The present study aimed to determine new criteria regarding surgical or observational treatment, especially concerning the fracture dislocation. Clinical information on 164 consecutive patients with fractures of the frontal sinus, treated at the Department of Craniomaxillofacial Surgery of the Medical University of Innsbruck from 2006 to 2010, have been evaluated. 23 female (14%) and 141 male (86%) patients suffered mainly from traffic (31.7%) and sports accidents (28.0%), followed by work accidents (20.1%), violence (3.7%) and accidents at home (3.1%). 51.8% presented an isolated fracture of the anterior wall, 47.6% both anterior and posterior wall fracture, 0.6% an isolated posterior wall fracture. Injury of the nasofrontal duct was found in 29.2%, CSF liquorrhoea in 15.9%. In total, 44.5% of the patients underwent surgical therapy, 55.5% were treated conservatively by observation. Treatment decision depended significantly on concomitant injuries of the nasofrontal duct and the presence of rhinoliquorrhoea as well as on the fracture dislocation. A new classification of frontal sinus fractures depending on their maximum dislocation is proposed. In addition, a treatment algorithm considering displacement, liquorrhoea and injury of the nasofrontal duct is presented.
authors.affiliation: Clinical Department of Craniomaxillofacial and Oral Surgery (Head: Prof. DDr. Rasse Michael), Medical University of Innsbruck, Austria. Electronic address: dr.dalla-torre@gmx.at.
authors.forename: Daniel
authors.initials: D
authors.lastname: Dalla Torre
authors.affiliation: Clinical Department of Restorative and Prosthetic Dentistry (Head: Prof. DDr. Grunert Ingrid), Medical University Innsbruck, Austria.
authors.forename: Doris
authors.initials: D
authors.lastname: Burtscher
authors.affiliation: Department of Medical Genetics, Molecular and Clinical Pharmacology (Head: Prof. Dr. Kronenberg Florian), Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Anita
authors.initials: A
authors.lastname: Kloss-Brandstätter
authors.affiliation: Clinical Department of Craniomaxillofacial and Oral Surgery (Head: Prof. DDr. Rasse Michael), Medical University of Innsbruck, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Rasse
authors.affiliation: Clinical Department of Craniomaxillofacial and Oral Surgery (Head: Prof. DDr. Rasse Michael), Medical University of Innsbruck, Austria.
authors.forename: Frank
authors.initials: F
authors.lastname: Kloss
mesh_terms: D000062:Accidents, Occupational; D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001265:Athletic Injuries / Q000601:surgery; D001930:Brain Injuries / Q000175:diagnosis; D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis; D002648:Child; D015331:Cohort Studies; D003657:Decision Making; D005004:Ethmoid Bone / Q000293:injuries; D005260:Female; D005500:Follow-Up Studies; D005626:Frontal Sinus / Q000293:injuries*; D006261:Headache / Q000209:etiology; D006801:Humans; D004204:Joint Dislocations / Q000145:classification / Q000601:surgery* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000293:injuries; D011183:Postoperative Complications; D012189:Retrospective Studies; D012887:Skull Fractures / Q000145:classification / Q000601:surgery* / Q000628:therapy; D016896:Treatment Outcome; D055815:Young Adult
keywords: Dislocation; Fracture; Frontal sinus; Management; Trauma; Treatment