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Three-Dimensional Reconstruction of Orbital Fractures
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Frontal sinus fracture management: a systematic review and meta-analysis
1Maxillofacial Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia; Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia; School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia.
International Journal of Oral and Maxillofacial Surgery
|August 31, 2020
Summary
This review of frontal sinus fracture treatments found that reconstruction is suitable for displaced fractures without nasofrontal outflow tract obstruction. Obliteration or cranialization is recommended for obstructed fractures, with CT scans monitoring sinus re-ventilation.
Area of Science:
- Neurosurgery
- Otolaryngology
- Trauma Surgery
Background:
- Frontal sinus fractures are complex injuries often associated with significant morbidity.
- Management strategies vary, necessitating a review of outcomes and complications.
Purpose of the Study:
- To systematically review literature on frontal sinus fracture management.
- To document measurable outcomes and complications of different treatment strategies.
Main Methods:
- Systematic review of randomized controlled trials, controlled clinical trials, and case series published up to October 2018.
- Included 24 publications detailing the management of 2388 patients.
- Analyzed complications using the Clavien-Dindo classification.
Main Results:
- Reconstruction is effective for displaced fractures without nasofrontal outflow tract (NFOT) obstruction.
- Obliteration or cranialization is indicated for NFOT obstruction.
- Endoscopic sinus surgery can serve as a salvage procedure for re-ventilation.
Conclusions:
- Treatment decisions for frontal sinus fractures should be guided by NFOT status and fracture displacement.
- Post-treatment monitoring with computed tomography is crucial for assessing sinus re-ventilation.
- Further research may refine optimal management protocols for complex cases.
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