Related Experiment Video
Updated: Apr 18, 2026
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Pediatric frontal sinus fractures: outcomes and treatment algorithm
Anthony T Vu1, Parit A Patel, Wendy Chen
1*Division of Plastic, Reconstructive, and Hand Surgery, University of Cincinnati, Cincinnati, Ohio †The Department of Plastic Surgery, New York University School of Medicine, New York, New York ‡University of Cincinnati College of Medicine, Cincinnati, Ohio §Division of Plastic Surgery, Cincinnati Children's Hospital, Cincinnati, Ohio.
Insights
Pediatric frontal sinus fractures, though rare, often accompany severe injuries. Treatment algorithms, primarily based on adults, are presented, recommending observation for non-NFOT involvement and surgery for NFOT or CSF leaks.
Area of Science:
- Trauma Surgery
- Pediatric Neurosurgery
- Craniofacial Surgery
Background:
- Pediatric frontal sinus fractures are rare but associated with significant intracranial and craniofacial injuries.
- Current treatment algorithms are largely derived from adult data, necessitating specific pediatric guidelines.
- Understanding injury patterns and outcomes is crucial for effective management.
Purpose of the Study:
- To present the experience and a treatment algorithm for pediatric frontal sinus fractures.
- To analyze demographics, injury patterns, treatments, and complications in pediatric patients.
- To identify factors associated with severe outcomes and guide management decisions.
Main Methods:
- Retrospective review of a pediatric trauma database (1998-2010).
- Inclusion of patients aged 0-18 with frontal sinus fractures.
- Analysis of demographics, fracture characteristics, associated injuries, treatments, and complications using descriptive statistics and univariate analyses.
Main Results:
- 39 pediatric patients with a mean follow-up of 31.2 months were analyzed.
- Displaced fractures (anterior/posterior tables) correlated with higher costs, high-velocity mechanisms, lower GCS scores, nasofrontal outflow tract (NFOT) involvement, and CSF leaks.
- No significant differences in short- or long-term complications were observed between treatment groups; however, surgical intervention (obliteration/cranialization) was more common in complex cases.
Conclusions:
- Nasofrontal outflow tract (NFOT) involvement is a critical factor in determining management strategy.
- Observation may be sufficient for pediatric frontal sinus fractures without NFOT involvement.
- Surgical intervention, such as obliteration or cranialization, is recommended for patients with NFOT involvement or persistent cerebrospinal fluid leaks to mitigate severe complications.
Abstract:
Pediatric frontal sinus fractures are a rare clinical entity. Owing to the large amount of force required to fracture the frontal sinus, it is often associated with severe intracranial and craniofacial injuries. The treatment of frontal sinus fractures is controversial, with many different established algorithms based mainly on the adult population. The authors present their experience with pediatric frontal sinus fractures; they also present a treatment algorithm. A retrospective review of the Cincinnati Children's Hospital Medical Center trauma database was performed. From 1998 to 2010, the authors identified patients between the ages of 0 and 18 with frontal sinus fractures and analyzed demographics, fracture pattern, associated injuries, methods of treatment, and complications. Descriptive statistics and univariate analyses were performed.A total of 39 patients were included in the study with a mean follow-up of 31.2 months. Fractures of the anterior and posterior table with displacement greater than one table width were significantly associated with higher hospital costs, higher velocity mechanism of injuries, lower Glasgow Coma Scale scores, nasofrontal outflow tract (NFOT) involvement, and cerebrospinal fluid leak. There were no differences in short- and long-term complications. Additionally, these patients were more likely to be treated surgically in the form of obliteration or cranialization.Patients without NFOT involvement can be managed with observation only. Patients with NFOT involvement or persistent cerebrospinal fluid leak should be treated with obliteration or cranialization, respectively, to reduce the risk of severe complications.
More Related Videos
07:11Treatment of Facial Deformities using 3D Planning and Printing of Patient-Specific Implants
Published on: May 23, 2020
08:03Midface Hypoplasia and Cranial Base Morphology in Syndromic Craniosynostosis: A Comparative Analysis Study Using a Predictive Regression Model
Published on: November 4, 2025
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:30Epistaxis
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...