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Frontal Sinus Surgery pp 227–237Cite as

Management of Frontal Sinus Trauma

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Abstract

The frontal bone is the strongest of the maxillofacial skeleton, and fractures involving the frontal sinus are relatively uncommon. Frontal sinus fractures are usually the result of high-speed motor vehicle accidents or assault. Management of these fractures is still controversial with regard to the timing, indications for surgical repair, surgical approach, and postoperative care. Complications include soft tissue, musculoskeletal, sinonasal, ophthalmological, and neurological.

Traditional management includes observation for nondisplaced anterior table fractures, open reduction/internal fixation for displaced anterior table fractures, and osteoplastic flap with obliteration or cranialization for posterior table fractures. However, there is mounting evidence that both anterior and posterior table fractures can be managed using transnasal endoscopic techniques in select cases with long-term success and maintenance of the frontal sinus drainage pathway.

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References

  1. Kalavrezos N. Current trends in the management of frontal sinus fractures. Injury. 2004;35(4):340–6.

    Article  PubMed  Google Scholar 

  2. Yavuzer R, et al. Management of frontal sinus fractures. Plast Reconstr Surg. 2005;115(6):79e–93e. discussion 94e-95e

    Article  PubMed  Google Scholar 

  3. Danesh-Sani SA, Bavandi R, Esmaili M. Frontal sinus agenesis using computed tomography. J Craniofac Surg. 2011;22(6):e48–51.

    Article  PubMed  Google Scholar 

  4. Stammberger HR, Kennedy DW, G. Anatomic Terminology. Paranasal sinuses:anatomic terminology and nomenclature. Ann Otol Rhinol Laryngol Suppl. 1995;167:7–16.

    Article  CAS  PubMed  Google Scholar 

  5. Gerbino G, et al. Analysis of 158 frontal sinus fractures: current surgical management and complications. J Craniomaxillofac Surg. 2000;28(3):133–9.

    Article  CAS  PubMed  Google Scholar 

  6. Larrabee WF Jr, Travis LW, Tabb HG. Frontal sinus fractures--their suppurative complications and surgical management. Laryngoscope. 1980;90(11 Pt 1):1810–3.

    Article  PubMed  Google Scholar 

  7. Wilson BC, et al. Comparison of complications following frontal sinus fractures managed with exploration with or without obliteration over 10 years. Laryngoscope. 1988;98(5):516–20.

    Article  CAS  PubMed  Google Scholar 

  8. Manolidis S, Hollier LH Jr. Management of frontal sinus fractures. Plast Reconstr Surg. 2007;120(7 Suppl 2):32S–48S.

    Article  CAS  PubMed  Google Scholar 

  9. Metzinger SE, Guerra AB, Garcia RE. Frontal sinus fractures: management guidelines. Facial Plast Surg. 2005;21(3):199–206.

    Article  CAS  PubMed  Google Scholar 

  10. Lakhani RS, et al. Titanium mesh repair of the severely comminuted frontal sinus fracture. Arch Otolaryngol Head Neck Surg. 2001;127(6):665–9.

    Article  CAS  PubMed  Google Scholar 

  11. Nathum AM. The biomechanics of facial bone fracture. Laryngoscope. 1975;85:140.

    Article  Google Scholar 

  12. Strong EB, Pahlavan N, Saito D. Frontal sinus fractures: a 28-year retrospective review. Otolaryngol Head Neck Surg. 2006;135(5):774–9.

    Article  PubMed  Google Scholar 

  13. Rodriguez IZ, et al. Posttraumatic frontal sinus obliteration with calvarial bone dust and demineralized bone matrix: a long term prospective study and literature review. Int J Oral Maxillofac Surg. 2013;42(1):71–6.

    Article  CAS  PubMed  Google Scholar 

  14. Sataloff RT, et al. Surgical management of the frontal sinus. Neurosurgery. 1984;15(4):593–6.

    Article  CAS  PubMed  Google Scholar 

  15. Piccolino P, et al. Frontal bone fractures: new technique of closed reduction. J Craniofac Surg. 2007;18(3):695–8.

    Article  PubMed  Google Scholar 

  16. Stanley RB Jr. Management of severe frontobasilar skull fractures. Otolaryngol Clin N Am. 1991;24(1):139–50.

    Google Scholar 

  17. Rohrich RJ, Hollier LH. Management of frontal sinus fractures. Changing concepts. Clin Plast Surg. 1992;19(1):219–32.

    CAS  PubMed  Google Scholar 

  18. Enepekides D, Donald P. Frontal sinus trauma. In: Stewart M, editor. Head, face, and neck trauma: comprehensive management. New York: Thieme Medical Publishers; 2005. p. 26–39.

    Google Scholar 

  19. Smith TL, et al. Endoscopic management of the frontal recess in frontal sinus fractures: a shift in the paradigm? Laryngoscope. 2002;112(5):784–90.

    Article  PubMed  Google Scholar 

  20. Jafari A, et al. Spontaneous ventilation of the frontal sinus after fractures involving the frontal recess. Am J Otolaryngol. 2015;36(6):837–42.

    Article  PubMed  Google Scholar 

  21. Gonty AA, Marciani RD, Adornato DC. Management of frontal sinus fractures: a review of 33 cases. J Oral Maxillofac Surg. 1999;57(4):372–9. discussion 380-1

    Article  CAS  PubMed  Google Scholar 

  22. Gossman DG, Archer SM, Arosarena O. Management of frontal sinus fractures: a review of 96 cases. Laryngoscope. 2006;116(8):1357–62.

    Article  PubMed  Google Scholar 

  23. Carter KB Jr, Poetker DM, Rhee JS. Sinus preservation management for frontal sinus fractures in the endoscopic sinus surgery era: a systematic review. Craniomaxillofac Trauma Reconstr. 2010;3(3):141–9.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Farwell DG, Strong EB. Endoscopic repair of orbital floor fractures. Otolaryngol Clin N Am. 2007;40(2):319–28.

    Article  Google Scholar 

  25. Kellman RM, Cienfuegos R. Endoscopic approaches to subcondylar fractures of the mandible. Facial Plast Surg. 2009;25(1):23–8.

    Article  CAS  PubMed  Google Scholar 

  26. Kim KK, et al. Endoscopic repair of anterior table: frontal sinus fractures with a Medpor implant. Otolaryngol Head Neck Surg. 2007;136(4):568–72.

    Article  PubMed  Google Scholar 

  27. Lee CH, et al. A cadaveric and clinical evaluation of endoscopically assisted zygomatic fracture repair. Plast Reconstr Surg. 1998;101(2):333–45. discussion 346-7

    Article  CAS  PubMed  Google Scholar 

  28. Pham AM, Strong EB. Endoscopic management of facial fractures. Curr Opin Otolaryngol Head Neck Surg. 2006;14(4):234–41.

    Article  PubMed  Google Scholar 

  29. Steiger JD, et al. Endoscopic-assisted reduction of anterior table frontal sinus fractures. Laryngoscope. 2006;116(10):1936–9.

    Article  PubMed  Google Scholar 

  30. Strong EB. Endoscopic repair of anterior table frontal sinus fractures. Facial Plast Surg. 2009;25(1):43–8.

    Article  CAS  PubMed  Google Scholar 

  31. Strong EB, Kim KK, Diaz RC. Endoscopic approach to orbital blowout fracture repair. Otolaryngol Head Neck Surg. 2004;131(5):683–95.

    Article  PubMed  Google Scholar 

  32. Chaaban MR, et al. Transnasal endoscopic repair of posterior table fractures. Otolaryngol Head Neck Surg. 2012;147(6):1142–7.

    Article  PubMed  Google Scholar 

  33. Lappert PW, Lee JW. Treatment of an isolated outer table frontal sinus fracture using endoscopic reduction and fixation. Plast Reconstr Surg. 1998;102(5):1642–5.

    Article  CAS  PubMed  Google Scholar 

  34. Chen DJ, et al. Endoscopically assisted repair of frontal sinus fracture. J Trauma. 2003;55(2):378–82.

    Article  PubMed  Google Scholar 

  35. Kim NH, Kang SJ. A simple aesthetic approach for correction of frontal sinus fracture. J Craniofac Surg. 2014;25(2):544–6.

    Article  CAS  PubMed  Google Scholar 

  36. Mavili ME, Canter HI. Closed treatment of frontal sinus fracture with percutaneous screw reduction. J Craniofac Surg. 2007;18(2):415–9.

    Article  PubMed  Google Scholar 

  37. Chen RF, et al. Optimizing closed reduction of nasal and zygomatic arch fractures with a mobile fluoroscan. Plast Reconstr Surg. 2010;126(2):554–63.

    Article  CAS  PubMed  Google Scholar 

  38. Forrest CR. Application of minimal-access techniques in lag screw fixation of fractures of the anterior mandible. Plast Reconstr Surg. 1999;104(7):2127–34.

    Article  CAS  PubMed  Google Scholar 

  39. Shumrick KA. Endoscopic management of frontal sinus fractures. Facial Plast Surg Clin North Am. 2006;14(1):31–5.

    Article  PubMed  Google Scholar 

  40. Graham HD, Spring P. Endoscopic repair of frontal sinus fracture: case report. J Craniomaxillofac Trauma. 1996;2(4):52–5.

    PubMed  Google Scholar 

  41. Rice DH. Management of frontal sinus fractures. Curr Opin Otolaryngol Head Neck Surg. 2004;12(1):46–8.

    Article  PubMed  Google Scholar 

  42. Verwoerd CD. Present day treatment of nasal fractures: closed versus open reduction. Facial Plast Surg. 1992;8(4):220–3.

    Article  CAS  PubMed  Google Scholar 

  43. Conger BT, Riley KO, Woodworth BW. The Draf III mucosal grafting technique: a prospective study. Otolaryngol Head Neck Surg. 2010;146(4):664–8.

    Article  Google Scholar 

  44. Chen KT, et al. Frontal sinus fractures: a treatment algorithm and assessment of outcomes based on 78 clinical cases. Plast Reconstr Surg. 2006;118(2):457–68.

    Article  CAS  PubMed  Google Scholar 

  45. Sailer HF, Gratz KW, Kalavrezos ND. Frontal sinus fractures: principles of treatment and long-term results after sinus obliteration with the use of lyophilized cartilage. J Craniomaxillofac Surg. 1998;26(4):235–42.

    Article  CAS  PubMed  Google Scholar 

  46. Raza SM, et al. Sensitivity and specificity of intrathecal fluorescein and white light excitation for detecting intraoperative cerebrospinal fluid leak in endoscopic skull base surgery: a prospective study. J Neurosurg. 2016;124(3):621–6.

    Article  CAS  PubMed  Google Scholar 

  47. Guimaraes RE, et al. Chemical and cytological analysis of cerebral spinal fluid after intrathecal injection of hypodense fluorescein. Braz J Otorhinolaryngol. 2015;81(5):549–53.

    Article  PubMed  Google Scholar 

  48. Placantonakis DG, et al. Safety of low-dose intrathecal fluorescein in endoscopic cranial base surgery. Neurosurgery. 2007;61(3 Suppl):161–5. discussion 165-6

    PubMed  Google Scholar 

  49. Tabaee A, et al. Intrathecal fluorescein in endoscopic skull base surgery. Otolaryngol Head Neck Surg. 2007;137(2):316–20.

    Article  PubMed  Google Scholar 

  50. Seth R, et al. The utility of intrathecal fluorescein in cerebrospinal fluid leak repair. Otolaryngol Head Neck Surg. 2010;143(5):626–32.

    Article  PubMed  Google Scholar 

  51. Banu MA, et al. Low-dose intrathecal fluorescein and etiology-based graft choice in endoscopic endonasal closure of CSF leaks. Clin Neurol Neurosurg. 2014;116:28–34.

    Article  PubMed  Google Scholar 

  52. Illing EA, Woodworth BA. Management of Frontal Sinus Cerebrospinal Fluid Leaks and Encephaloceles. Otolaryngol Clin N Am. 2016;49(4):1035–50.

    Article  Google Scholar 

  53. Alexander NS, et al. Treatment strategies for lateral sphenoid sinus recess cerebrospinal fluid leaks. Arch Otolaryngol Head Neck Surg. 2012;138(5):471–8.

    Article  PubMed  Google Scholar 

  54. Illing EA, et al. Draf III mucosal graft technique: long-term results. Int Forum Allergy Rhinol. 2016;6(5):514–7.

    Article  PubMed  Google Scholar 

  55. Kostrzewa JP, et al. Radiofrequency coblation decreases blood loss during endoscopic sinonasal and skull base tumor removal. ORL J Otorhinolaryngol Relat Spec. 2010;72(1):38–43.

    Article  PubMed  Google Scholar 

  56. Smith N, Riley KO, Woodworth BA. Endoscopic Coblator-assisted management of encephaloceles. Laryngoscope. 2010;120(12):2535–9.

    Article  PubMed  Google Scholar 

  57. Virgin FW, Bleier BS, Woodworth BA. Evolving materials and techniques for endoscopic sinus surgery. Otolaryngol Clin N Am. 2010;43(3):653–72. xi

    Article  Google Scholar 

  58. Illing E, et al. Porcine small intestine submucosal graft for endoscopic skull base reconstruction. Int Forum Allergy Rhinol. 2013;3(11):928–32.

    Article  PubMed  Google Scholar 

  59. Hadad G, et al. A novel reconstructive technique after endoscopic expanded endonasal approaches: vascular pedicle nasoseptal flap. Laryngoscope. 2006;116(10):1882–6.

    Article  PubMed  Google Scholar 

  60. Virgin F, et al. Frontal sinus skull base defect repair using the pedicled nasoseptal flap. Otolaryngol Head Neck Surg. 2011;145(2):338–40.

    Article  PubMed  Google Scholar 

  61. Adelson RT, Wei C, Palmer JN. Frontal sinus fractures. In: Palmer JN, Chiu AG, Adappa ND, editors. Atlas of endoscopic and Sinonasal skull base surgery. Pennsylvania: Elsevier; 2013. p. 337–56.

    Google Scholar 

  62. Emara TA, et al. Frontal sinus fractures with suspected outflow tract obstruction: a new approach for sinus preservation. J Craniomaxillofac Surg. 2015;43(1):1–6.

    Article  PubMed  Google Scholar 

  63. Dolan RW. Facial plastic, reconstructive, and trauma surgery. New York: Marcel Dekker; 2004.

    Google Scholar 

  64. Poetker DM, Smith TL. Endoscopic treatment of the frontal sinus outflow tract in frontal sinus trauma. Oper Tech Otolaryngol Head Neck Surg. 2006;17(1):66–72.

    Article  Google Scholar 

  65. Rodriguez ED, et al. Twenty-six year experience treating frontal sinus fractures: a novel algorithm based upon anatomical fracture pattern and failure of conventional techniques. Plast Reconstr Surg. 2008;122(6):1850–66.

    Article  CAS  PubMed  Google Scholar 

  66. Koudstaal MJ, et al. Post-trauma mucocele formation in the frontal sinus; a rationale of follow-up. Int J Oral Maxillofac Surg. 2004;33(8):751–64.

    Article  CAS  PubMed  Google Scholar 

  67. Jessica W, Grayson M, Jeyarajan H, Illing EA, Cho D-Y, Riley KO, Woodworth BA. Changing the surgical dogma in frontal sinus trauma: Transnasal endoscopic repair. Int Forum Allergy Rhinol. 2017;7:441.

    Article  Google Scholar 

  68. Woodworth BA, Schlosser RJ, Palmer JN. Endoscopic repair of frontal sinus cerebrospinal fluid leaks. J Laryngol Otol. 2005;119(09):709–13.

    Article  CAS  PubMed  Google Scholar 

  69. Jones V, et al. Changing paradigms in frontal sinus cerebrospinal fluid leak repair. Int Forum Allergy Rhinol. 2012;2(3):227–32.

    Article  PubMed  Google Scholar 

  70. Pollock RA, et al. Cranialization in a cohort of 154 consecutive patients with frontal sinus fractures (1987-2007): review and update of a compelling procedure in the selected patient. Ann Plast Surg. 2013;71(1):54–9.

    Article  CAS  PubMed  Google Scholar 

  71. Bell RB, et al. A protocol for the management of frontal sinus fractures emphasizing sinus preservation. J Oral Maxillofac Surg. 2007;65(5):825–39.

    Article  PubMed  Google Scholar 

  72. Conger BT, et al. Management of lateral frontal sinus pathology in the endoscopic era. Otolaryngol Head Neck Surg. 2014;15(1):159–63.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Otolaryngology, University of Texas Medical Branch, Galveston, TX, USA

    Mohamad Raafat Chaaban

  2. Department of Otolaryngology, University of Alabama at Birmingham, Gregory Fleming James Cystic Fibrosis Research Center, Birmingham, AL, USA

    Bradford A. Woodworth

Authors
  1. Mohamad Raafat Chaaban
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  2. Bradford A. Woodworth
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Editor information

Editors and Affiliations

  1. Prof of Otolaryngology, Mayo Clinic College of Medicine and Science, Associate Dean, Mayo Clinic School of Continuous Professional Development, Consultant, Dept of Otolaryngology-Head and Neck Surgery, Consultant (Joint), Dept of Neurological Surgery, Mayo Clinic, Phoenix, AZ, USA

    Devyani Lal

  2. Professor and Chief, Division of Rhinology and Endoscopic Skull Base Surgery, Department of Otolaryngology – Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA

    Peter H. Hwang

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Chaaban, M.R., Woodworth, B.A. (2019). Management of Frontal Sinus Trauma. In: Lal, D., Hwang, P. (eds) Frontal Sinus Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-97022-6_15

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  • DOI: https://doi.org/10.1007/978-3-319-97022-6_15

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  • Online ISBN: 978-3-319-97022-6

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