Subbrow approach as a minimally invasive reduction technique in the management of frontal sinus fractures.
BACKGROUND
Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are still controversial. In this article, we suggest a simple reduction method using a subbrow incision as a treatment for isolated anterior sinus fractures.


METHODS
Between March 2011 and March 2014, 13 patients with isolated frontal sinus fractures were treated by open reduction and internal fixation through a subbrow incision. The subbrow incision line was designed to be precisely at the lower margin of the brow in order to obtain an inconspicuous scar. A periosteal incision was made at 3 mm above the superior orbital rim. The fracture site of the frontal bone was reduced, and bone fixation was performed using an absorbable plate and screws.


RESULTS
Contour deformities were completely restored in all patients, and all patients were satisfied with the results. Scars were barely visible in the long-term follow-up. No complications related to the procedure, such as infection, uncontrolled sinus bleeding, hematoma, paresthesia, mucocele, or posterior wall and brain injury were observed.


CONCLUSIONS
The subbrow approach allowed for an accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by providing a direct visualization of the fracture. Considering the surgical success of the reduction and the rigid fixation, patient satisfaction, and aesthetic problems, this transcutaneous approach through a subbrow incision is concluded to be superior to the other reduction techniques used in the case of an anterior table frontal sinus fracture.
Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Yewon
Y
Lee
Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Hyun Gon
HG
Choi
Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Dong Hyeok
DH
Shin
Department of Plastic and Reconstructive Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
Ki Il
KI
Uhm
Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Chungju, Korea.
Soon Heum
SH
Kim
Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Chungju, Korea.
Cheol Keun
CK
Kim
Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Chungju, Korea.
Dong In
DI
Jo
Fracture fixation, internal; Frontal sinus; Surgical procedures, minimally invasive