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Contemporary Management of Frontal Sinus Fractures.

Tsung-Yen Hsieh1, Mary Roz Timbang2, E Bradley Strong3

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|April 23, 2025
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Frontal sinus fractures from high-energy trauma need careful management to avoid complications. This review covers anatomy, diagnosis, and treatments, emphasizing sinus preservation and advanced surgical options for severe injuries.

Keywords:
CranializationCraniomaxillofacial fractureFrontal sinusFrontal sinus fractureSinus surgery

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Area of Science:

  • Otolaryngology
  • Neurosurgery
  • Trauma Surgery

Background:

  • Frontal sinus fractures result from significant trauma.
  • Potential complications include cosmetic deformities, sinus dysfunction, CSF leaks, chronic sinusitis, and mucoceles.
  • Accurate evaluation and management are crucial to prevent these long-term issues.

Purpose of the Study:

  • To provide a comprehensive review of frontal sinus anatomy.
  • To outline diagnostic protocols for frontal sinus fractures.
  • To discuss evolving treatment strategies, including surgical techniques.

Main Methods:

  • Review of existing literature on frontal sinus anatomy, trauma, and management.
  • Presentation of an anatomically based treatment algorithm.
  • Discussion of advanced surgical techniques such as endoscopic sinus surgery and cranialization.

Main Results:

  • Anatomical considerations are key to successful management.
  • A treatment algorithm prioritizing sinus preservation and conservative approaches is proposed.
  • Endoscopic sinus surgery and cranialization are effective for severe injuries.

Conclusions:

  • Effective management of frontal sinus fractures requires understanding anatomy and employing appropriate diagnostic and treatment protocols.
  • Conservative strategies and sinus preservation should be prioritized.
  • Advanced surgical interventions are necessary for complex or severe cases.