Frontal Sinus Fractures: An Evaluation of Injury Parameters and Operative Variables on Surgical Outcomes

Area of Science:

• Neurosurgery
• Trauma Surgery
• Craniofacial Surgery

Background:

• Frontal sinus (FS) injuries are associated with significant morbidity.
• Current treatment approaches for frontal sinus and frontobasal trauma lack universal consensus.

Purpose of the Study:

• To evaluate surgical outcomes in frontal reconstruction.
• To determine the impact of fracture patterns and operative variables on complication rates in FS injuries.

Main Methods:

• Retrospective cross-sectional study of 137 patients with FS fractures (2015-2022).
• Analysis of electronic patient records and CT scans for demographics, injury parameters, surgical techniques, and complications.
• Statistical analysis using Pearson's chi-square, Mann-Whitney U, and Kruskal-Wallis H tests.

Main Results:

• 13.2% of surgically treated patients (n=12/91) experienced major complications.
• Rates of return to theatre (RTT) for CSF leaks, infection, and haematoma were 5.5%, 5.5%, and 2.2% respectively.
• FS fracture complexity predicted RTT and CSF leaks (p=0.015). Frontobasal complexity predicted post-operative infection (p=0.047). Neurosurgical involvement and cranialisation predicted infection, CSF leaks, and RTT.

Conclusions:

• Understanding risk profiles is vital for managing FS fractures, mitigating complications, and patient education.
• Further research into medical and social risk factors influencing complication rates is warranted.