Management of frontal sinus fractures requiring surgical intervention: An analysis of a case series

Otolaryngol Pol. 2024 Feb 29;78(1):8-13. doi: 10.5604/01.3001.0053.8591.

Abstract

<b><br>Introduction:</b> Isolated frontal bone fractures constitute 5-15% of traumatic facial fractures cases, with frontal sinus fractures categorized into anterior wall, posterior wall, or complex fractures. The approach is tailored to fracture type and bone fragment displacement. This paper presents the summary of surgical management in patients with isolated and complex fractures of the anterior wall of the frontal sinus.</br> <b><br>Material and Methods:</b> Five patients with different frontal sinus fractures were treated surgically. The same management protocol - diagnosis and surgical intervention was implemented in all cases The retrospective analysis included fracture assessment, surgical approach, and long-term outcomes evaluation.</br> <b><br>Results:</b> The most common cause of fractures was falls, while two complex fractures involved the anterior and posterior walls. External approach, bone fragment removal, endoscopy, and external stabilization were employed in all cases. One patent required delayed revision surgery due to retaining metallic foreign body. Follow-up radiological examinations showed proper healing and cosmetic outcomes were satisfactory in all of the cases.</br> <b><br>Conclusion:</b> Surgical management of isolated fractures of the frontal sinus anterior wall, involving bone fragment removal, realignment, and endoscopy, yielded satisfactory functional and cosmetic outcomes without internal or external stabilization. Long-term monitoring and symptom assessment are crucial, especially in cases with penetrating injuries and foreign body risk.</br&gt.

Keywords: anterior wall of the frontal sinus; forehead asymmetry; frontal bone fractures; frontal bone necrosis; frontal sinus injury; isolated frontal bone fractures; nasal endoscopy.

MeSH terms

  • Foreign Bodies*
  • Frontal Sinus* / diagnostic imaging
  • Frontal Sinus* / injuries
  • Frontal Sinus* / surgery
  • Humans
  • Retrospective Studies
  • Skull Fractures* / diagnostic imaging
  • Skull Fractures* / etiology
  • Skull Fractures* / surgery
  • Tomography, X-Ray Computed