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Related Concept Videos

Epistaxis01:30

Epistaxis

504
Epistaxis, or nosebleeds, occurs when small, swollen blood vessels in the nasal mucous membrane rupture. Typically, the anterior septum is the primary site of occurrence.
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...
504

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Frontal Sinus Fracture Management: A Single-Center 13-Year Retrospective Analysis.

Milovan V Dimitrijevic1,2, Aleksandar M Krstic2, Goran M Stojkovic1,2

  • 1Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

ORL; Journal for Oto-Rhino-Laryngology and Its Related Specialties
|November 27, 2025
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Summary

An algorithm-guided approach to frontal sinus fracture management improves outcomes. Surgical intervention for nasofrontal duct obstruction or CSF leakage reduces complications compared to conservative treatment.

Keywords:
FracturesFrontal sinusManagementOsteosynthesisSurgerySurgical trainingTrauma

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Area of Science:

  • Craniofacial Trauma Surgery
  • Neurosurgery
  • Plastic and Reconstructive Surgery

Background:

  • Frontal sinus fractures necessitate individualized management due to complexity, nasofrontal duct involvement, and CSF leakage.
  • Optimal treatment strategies for frontal sinus fractures are debated, with a trend towards conservative management.
  • A standardized algorithm was used to evaluate treatment outcomes for frontal sinus fractures over 13 years.

Purpose of the Study:

  • To assess treatment outcomes for frontal sinus fractures using a standardized management algorithm.
  • To compare complication rates between surgical and conservative management strategies.
  • To identify factors influencing treatment decisions and outcomes in frontal sinus fractures.

Main Methods:

  • Retrospective review of 201 patients with frontal sinus fractures (2007-2020).
  • Fracture classification based on anterior/posterior wall involvement.
  • Management strategies included observation, open reduction internal fixation (ORIF), and cranialization, guided by NFD obstruction, posterior wall involvement, or CSF leakage.

Main Results:

  • 189 of 201 patients underwent surgical treatment, with ORIF in 76.2% and cranialization in 17%.
  • Surgical treatment had a 10.6% complication rate (infection, delayed healing) versus 25% in the conservative group.
  • High-energy trauma, especially traffic accidents, caused most fractures, predominantly in young males.

Conclusions:

  • An individualized, algorithm-guided approach to frontal sinus fracture management yields favorable outcomes and lower complication rates.
  • Surgical intervention is advantageous for fractures with nasofrontal duct obstruction or CSF leakage.
  • Structured, multidisciplinary decision-making optimizes treatment for complex craniofacial trauma.