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Frontal sinus fractures in children.
Wesley S Whatley1, David W Allison, Rakesh K Chandra
1Department of Otolaryngology--Head and Neck Surgery, University of Tennessee Health Science Center, Memphis, 38163, USA. wwhatley@midsouth.rr.com
The Laryngoscope
|October 14, 2005
Summary
Pediatric frontal sinus fractures often accompany other facial injuries and carry a higher risk of severe intracranial injury and cerebrospinal fluid (CSF) leaks in children compared to adults. Management requires a multidisciplinary approach.
Area of Science:
- Pediatric Traumatology
- Craniofacial Surgery
- Neurosurgery
Background:
- Frontal sinus fractures are relatively uncommon in children.
- Understanding their unique presentation and associated risks is crucial for optimal management.
Purpose of the Study:
- To review the epidemiologic characteristics, clinical course, and management of pediatric patients with frontal sinus fractures.
- To identify associated injuries and outcomes in this specific population.
Main Methods:
- Retrospective review of 11 pediatric patients with frontal sinus fractures treated between 1998 and 2003.
- Analysis of injury mechanisms, concomitant maxillofacial and intracranial injuries, and management strategies.
Main Results:
- The most common injury mechanisms were motor vehicle and all-terrain vehicle accidents.
- All patients had orbital fractures; 63.6% sustained significant intracranial injuries, including hemorrhage and subdural hematoma.
- Cerebrospinal fluid (CSF) leaks occurred in 4 patients, with the cribriform area being the most common site of dural injury.
Conclusions:
- Pediatric frontal sinus fractures are frequently associated with orbital and significant intracranial injuries.
- Children with these fractures face a higher risk of intracranial injury and CSF leaks compared to adults.
- A multidisciplinary approach is essential for managing these complex injuries and ensuring functional and cosmetic outcomes.