[Results of multidisciplinary treatment of frontal sinus fractures]

The aim of the study was to present the results of our management of frontal sinus fractures.

We analyzed records of 101 patients treated between 1996 and 2002, who sustained frontal sinus fractures. 7 patients were women and 94 were men. The average age of patients was 34 years. We analysed: circumstance of frontal sinus injury, frontal sinus fracture patterns, associated facial tissue and bone injuries, central nervous system injuries, perioperative management, timing of operation, surgical procedures and complications.

30 patients had anterior table fractures (type I), 51 had anterior and posterior table fractures (type II = 50, type IV = 1), 20 had posterior table fractures (type III). 22 patients were managed medically, 79 surgically. In 74 cases a combined, one-stage surgical procedure with neurosurgeons was performed, in 4 cases with an ophthalmologist, in 31 cases associated facial bone fractures were surgically managed. The average length of hospitalization was 16 days. There were 19 cases (24%) of postoperative complications, mostly early and late CSF leakage (12 patients). Inflammatory complications included acute frontal sinusitis (3 patients) and postoperative wound infection (1 patient).

Multidisciplinary one-stage surgical treatment of patients suffering from frontal sinus fractures associated with central nervous system and facial injuries optimizes treatment results and minimizes postoperative complications. A significant reduction in early and late postoperative inflammatory complications confirms the efficiency of nasofrontal duct recanalization with frontal sinus reconstruction.