Current Concepts in Frontal Sinus Fracture Management.

Area of Science:

• Neurosurgery
• Otolaryngology
• Trauma Surgery

Background:

• Frontal sinus fractures result from high-energy trauma.
• Potential complications include cosmetic deformity, CSF leaks, chronic sinusitis, and mucoceles.

Purpose of the Study:

• To outline frontal sinus anatomy, diagnostic methods, and current treatment concepts.
• To emphasize an anatomically driven algorithm for managing frontal sinus fractures.
• To review advanced surgical techniques for severe injuries.

Main Methods:

• Detailed review of frontal sinus anatomy and pathophysiology.
• Analysis of diagnostic pathways for fracture assessment.
• Evaluation of treatment algorithms, including conservative and surgical options.

Main Results:

• Management decisions hinge on anterior table, posterior table, and nasofrontal outflow tract status.
• Endoscopic techniques and evidence favor less invasive strategies for most injuries.
• Open procedures are reserved for higher-grade frontal sinus fractures.

Conclusions:

• Conservative management and preservation of sinus function are preferred when feasible.
• Endoscopic sinus surgery and cranialization are options for severe injuries.
• Long-term follow-up is crucial for detecting delayed complications like mucoceles and chronic sinusitis.