title: Surgical treatment of severe frontal bone fracture.
abstract: Craniofacial trauma can lead to several complications. The combined fractures of anterior and posterior walls of the frontal bone are almost always followed by lesions in nasofrontal orifices and disruption of nasofrontal ostia or ducts, a significant factor for the development of early and late complications after sinus fractures. This article reports a case of trauma patient, who underwent neurological evaluation and at first showed good general condition. Computed tomography noted fracture of the anterior and posterior walls of the frontal sinus and small foci of pneumocephalus in the cerebral cortex. The patient was monitored periodically and 9 days after trauma showed increased areas of pneumocephalus in prefrontal cortex, cerebrospinal fluid draining, and large dura mater lesion, with signs of necrosis and inflammation (meningitis). The necrotic tissues were removed, and dura mater was repaired through the approximation with resorbable wire polyglactin 910 5-0, oxidized cellulose application, and bonding with human fibrin sealant (fibrinogen, thrombin, and calcium chloride). Sinusectomy, frontal sinus, and nasofrontal duct obliteration with pedicled pericranium flap were performed. Tomographically, a reanatomization was noted in frontal region, and a 12-month follow-up showed no complication. The use of fibrin glue to repair dura mater lacerations, as well as the pedicle pericranium flap for frontal sinus and nasofrontal duct obliteration, is an efficient method for treating fractures of the frontal bone.
authors: *Aracatuba Dental School, Univ Estadual Paulista (UNESP), Aracatuba Dental School, Univ Estadual Paulista (UNESP) †Beneficent Portuguese Hospital, Bauru, São Paulo, Brazil.
authors: Leonardo Perez
authors: LP
authors: Faverani
authors: Sabrina
authors: S
authors: Ferreira
authors: Gustavo Antonio Correa
authors: GA
authors: Momesso
authors: Matheus
authors: M
authors: da Silva Brasilino
authors: Rafael Santiago
authors: RS
authors: de Almeida
authors: Pedro Henrique Silva
authors: PH
authors: Gomes-Ferreira
authors: Francisley Ávila
authors: FÁ
authors: Souza
authors: Idelmo Rangel
authors: IR
authors: Garcia-Júnior
mesh_terms: D003399:Craniotomy / Q000379:methods*; D005592:Fracture Fixation / Q000379:methods*; D005624:Frontal Bone / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008297:Male; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult