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Traumatic Frontal Sinus Fractures Management: Experience from High-Trauma Centre
Hieder Al-Shami1, Ahmad K Alnemare2, Turki Bin Mahfoz3
1Department of Neurosurgery, Al-Ahly Bank Hospital, Cairo, Egypt.
Korean Journal of Neurotrauma
|May 13, 2021
Summary
Frontal sinus fractures require careful consideration of anatomy and potential complications like CSF leakage. An institutional algorithm aids young neurosurgeons in managing these complex traumatic brain injuries effectively.
Area of Science:
- Neurosurgery
- Traumatology
- Skull Base Surgery
Background:
- Frontal sinus fractures are complex injuries often associated with traumatic brain injury.
- Optimal management requires a thorough understanding of anatomy, particularly the naso-frontal outflow tract.
Purpose of the Study:
- To analyze traumatic brain injury data focusing on frontal sinus fractures.
- To develop a decision-making framework for young neurosurgeons managing these injuries.
- To review current literature and assess planning strategies.
Main Methods:
- Retrospective analysis of a hospital head trauma database (2010-2020).
- Identification of patients with frontal sinus fractures and head trauma using a flowchart.
- Data collection on demographics, injury mechanisms, CSF leakage, associated injuries, imaging, and surgical techniques.
Main Results:
- 382 patients were included; 53.9% treated conservatively, 46.1% surgically.
- The majority of patients were male (84%), with a mean age of 36.2 years.
- Associated injuries included depressed skull fractures (17.61%), and CSF leakage occurred in 32.95% of patients.
Conclusions:
- Frontal sinus fractures present a complex clinical scenario demanding expertise in anatomy, outflow tract status, CSF leakage, and neurological injury.
- An institutional algorithm offers a rapid, accessible treatment protocol for residents and young neurosurgeons.
- This protocol aims to streamline management and reduce interdisciplinary consultations.
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