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Fractures of the frontal sinus: classification and its implications for surgical treatment
1Department of Plastic and Reconstructive Surgery, Middlesex Hospital, University College Hospitals, London, England.
Purpose:
To propose a clinical classification of fractures of the frontal sinus and discuss the implications on treatment.
Patients And Methods:
One hundred patients with fractures of the frontal sinus seen and operated on in two University hospital units (Leuven and Nijmegen). The majority of the patients were surgically treated according to a protocol based on the proposed classification. Fractures were classified according to their location, extent, involvement of the nasofrontal duct, and injury to the dura. Fragments were reduced and fixed, defects were reconstructed with autologous bone grafts, and the sinus cavity was drained, obliterated, or cranialized. In the latter cases, the sinus mucosa was thoroughly removed before obliteration or cranialization.
Results:
The follow-up ranged from 6 months to 12 years. There were functional complications in 4% of patients. Minor aesthetic sequelae were noticed in 14% of the patients.
Conclusion:
A detailed classification of fractures of the frontal sinus is proposed. It has helped the authors set up a treatment protocol. Optimally, if used by clinicians, it will contribute to a more standardized method of surgical care of patients with such injuries.