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Review
. 2013 Sep;6(3):155-60.
doi: 10.1055/s-0033-1349210. Epub 2013 Jun 26.

Frontal sinus fractures: a conservative shift

William M Weathers  1 , Erik M Wolfswinkel  1 , Daniel A Hatef  1 , Edward I Lee  1 , Rodger H Brown  1 , Larry H Hollier Jr  1
Affiliations
Review

Frontal sinus fractures: a conservative shift

William M Weathers et al. Craniomaxillofac Trauma Reconstr. 2013 Sep.

Abstract

This article reflects on the changing management of frontal sinus fractures. Severity of these injuries has decreased tremendously since the universal adoption of seat belts and air bags. Recently, there has been a shift from aggressive surgical management to more conservative management strategies, some forgoing surgery all together. New technologies, such as bioabsorbable plates and endoscopic sinus surgery, are leading the way in improved surgical management strategies and offer promising alternatives to the more traditional approaches.

Keywords: cranialization; frontal sinus fractures; injury; nasofrontal duct; sinus obliteration.

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Figures

Figure 1
Figure 1
Computed tomography slice demonstrating involvement of the medial orbital wall and the ethmoids associated with a frontal sinus fracture. It should be assumed that the nasofrontal duct is injured with these findings.
Figure 2
Figure 2
Microplate fixation of an anterior table fracture.
Figure 3
Figure 3
Operative photo of a mucocele that formed a year after initial repair of frontal sinus fracture.
Figure 4
Figure 4
(A) Intraoperative picture of a cranialization procedure before exclusion of the sinonasal tract. (B) Intraoperative picture demonstrating exclusion of the sinonasal tract using a pericranial flap.
Figure 5
Figure 5
Computed tomography (CT) scan follow-up after conservative management following anterior and posterior table injuries. (A) Initial CT scan at the time of injury. (B) A 3-month follow-up CT scan demonstrating no complications and adequate bony healing. If the frontal sinus is opacified, this may indicate an occult nasofrontal duct injury.
See this image and copyright information in PMC

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