Digitally Guided Frontal Sinus Fracture Fixation: A Point-of-Care "In-House" Biomodel Protocol with...

Area of Science:

• Craniofacial surgery
• Digital imaging and modeling
• Biomaterials science

Background:

• Comminuted frontal sinus fractures present challenges in achieving stable osteosynthesis due to small, irregular fragments.
• Aesthetic deformity is a common sequela of untreated or poorly managed anterior frontal sinus wall fractures.
• Conventional fixation methods may be insufficient for complex fragment configurations.

Purpose of the Study:

• To describe a point-of-care digital workflow for managing isolated comminuted anterior frontal sinus wall fractures.
• To evaluate the efficacy of 3D planning and printing combined with cyanoacrylate-assisted fixation.
• To assess the restoration of forehead contour and fragment stability.

Main Methods:

• A patient with a comminuted frontal sinus fracture underwent a digital workflow including 3D biomodel-guided planning and extracorporeal reconstruction.
• Modified N-butyl-2-cyanoacrylate adhesive (Glubran 2) was used as an adjunct fixation method.
• Titanium microplates were employed for additional reinforcement of the reconstructed anterior wall.

Main Results:

• The 3D-printed biomodel facilitated precise visualization and anatomical reassembly of fracture fragments.
• The cyanoacrylate adhesive aided in maintaining fragment reduction, particularly where screw purchase was limited.
• The combined approach resulted in immediate restoration of forehead contour, satisfactory alignment, and an uneventful postoperative recovery.

Conclusions:

• Point-of-care 3D biomodeling integrated with cyanoacrylate adhesive is a feasible adjunct to microplate fixation for comminuted frontal sinus fractures.
• This digital workflow enhances fragment handling and improves aesthetic outcomes in complex cases.
• The technique preserves sinonasal drainage and avoids the need for sinus obliteration.