[Fractures of the frontal sinus. Therapeutic indications]

Attitudes towards therapy of frontal sinus fractures, in the Plastic and Maxillofacial Surgical Department of the Foch Medical-Surgical Unit, are discussed. Only those fractures with displacement, a possible cause of complications, are envisaged, the conduct adopted being described in detail as a function of the wall affected. Treatment should be directed along the following lines: --A harmonious frontal outline can be obtained by osteosynthesis of the bone fragments if certain conditions are fulfilled, or by a bone graft. --The sinus cavity should be excluded and filled by spongy grafts when an anterior wall graft is inserted. --Neurosurgical explorations are necessary if a posterior wall defect provides a threat to the meninges, followed by cranialization and obturation of the nasofrontal canal. --Physiological drainage must be ensured for the sinus cavity, particularly in inferior wall fractures.