[Injuries of the frontal sinus]

Area of Science:

• Neurosurgery
• Otolaryngology
• Trauma Surgery

Background:

• Frontal sinus fractures are complex injuries requiring careful management.
• Previous studies highlight the challenges in treating these fractures, particularly regarding complications like cerebrospinal fluid (CSF) leaks.
• A review of surgical interventions and outcomes is crucial for refining treatment protocols.

Purpose of the Study:

• To analyze the surgical treatment of frontal sinus fractures over a decade.
• To identify critical factors influencing treatment decisions in frontal sinus trauma.
• To evaluate the efficacy of different surgical approaches, including cranialization and open reduction.

Main Methods:

• Retrospective review of 67 cases of frontal sinus fractures treated between 1979 and 1987.
• Classification of fractures based on involvement of anterior and/or posterior walls and presence of CSF rhinorrhea.
• Surgical interventions included cranialization (30%) and open reduction with reconstruction (48%), with or without nasofrontal duct stenting.

Main Results:

• 52% of trauma cases involved isolated anterior and/or posterior frontal sinus wall fractures, with or without CSF rhinorrhea.
• Cranialization was performed in 20 cases (30%), and open reduction with reconstruction in 30 cases (48%).
• Nasofrontal duct injury and osteomeningeal tears were identified as critical determinants for surgical strategy.

Conclusions:

• Treatment of frontal sinus fractures necessitates careful evaluation of nasofrontal duct integrity and associated osteomeningeal tears.
• Surgical management strategies should be tailored based on these critical injury parameters.
• Long-term outcomes and complication rates associated with different surgical techniques warrant further investigation.