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. 2019 Sep;12(3):241-248.
doi: 10.1055/s-0038-1675560. Epub 2019 Feb 19.

Frontal Sinus Fractures: Management and Complications

Xi Lin Jing  1 , Edward Luce  1
Affiliations

Frontal Sinus Fractures: Management and Complications

Xi Lin Jing et al. Craniomaxillofac Trauma Reconstr. 2019 Sep.

Abstract

Frontal sinus fractures are relatively rare maxillofacial injuries (only 5-15% of all facial fractures). The appropriate management of frontal sinus fracture and associated pathology is controversial. Diagnosis and treatment of frontal sinus fractures has improved with the advances of high-resolution computed tomography technology. Treatment of frontal sinus fractures depends on several factors, including contour deformity of anterior table; the presence of CSF leak or air-fluid level in the sinus, likelihood of nasofrontal duct obstruction, and degree of displacement of posterior table. Nasofrontal duct patency should be checked if fracture pattern is highly suspicious of ductal injury. Cranialization is performed in cases of severely comminuted posterior wall fracture. Long-term complication of frontal sinus fracture can occur up to 10 years after initial injury or intervention; so, judicious long-term follow-up is warranted. This article presents the management and complications of frontal sinus fractures.

Keywords: calvarial bone graft; complications; frontal sinus fracture; management.

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Conflict of interest statement

Conflict of Interest None.

Figures

Fig. 1
Fig. 1
( a ) Lateral views of a patient with large forehead and glabellar laceration and frontal sinus fracture. ( b ) Lateral view of the same patient in a following rigid fixation with split calvarial bone graft.
Fig. 2
Fig. 2
Axial computed tomographic image of a patient with disrupted nasofrontal duct.
Fig. 3
Fig. 3
( a ) Intraoperative view demonstrates polyethylene catheters cannulating nasofrontal ducts. ( b ) Cottonoids with stained methylene blue demonstrating patent nasofrontal ducts.
Fig. 4
Fig. 4
Intraoperative view of frontal sinus with pericranial flap.
Fig. 5
Fig. 5
( a–d ) Cranialization of the frontal sinus using bone fragments and pericranial flap. Appearance of patient after rigid anatomic fixation.
Fig. 6
Fig. 6
Intraoperative view of a split calvarial bone graft.
Fig. 7
Fig. 7
Frontal view of a patient with untreated frontal sinus fracture; note the visible deformity of the forehead.
See this image and copyright information in PMC

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