Endoscopic transnasal reduction of an anterior table frontal sinus fracture: technical note

Repair of an isolated anterior table frontal sinus fracture traditionally requires a coronal incision, which results in a large scar, alopecia and paresthesias, because of these problems, endoscopic approaches have been attempted. These approaches still involve small incisions at the forehead or behind the hairline so might be better described as endoscopy-assisted surgery. This report describes the reduction of an isolated anterior table frontal sinus fracture in a 14-year-old boy using an endoscopic procedure that involves a transnasal approach with no external incisions. Endoscopic instruments were used under 25 and 70 degrees endoscope guidance. A custom-made latex glove balloon was inserted into the frontal sinus, and then expanded and maintained for 20 days to support the reduced bony fragments. Postoperatively, the reduction was successful. The cosmetic deformity was repaired and there was no postoperative morbidity. This case indicates that endoscopic reduction may be a valuable treatment option for certain types of frontal sinus fractures.