Fractures of the frontal sinus: a rationale of treatment

There is still controversy on the management of frontal sinus fractures, as the optimal method of treatment has not been developed yet. Based on experience with 71 patients we formed a protocol, the basic principles of which are outlined here. In cases of posterior wall fractures the sinus was either cranialised or it was obliterated down to the nasofrontal duct. Anterior table fractures were reduced, defects were reconstructed and the sinus was drained via the nose for 4-6 weeks. Autologous graft material was always used for all reconstructive purposes. Meningitis occurred directly after the operation in 2 patients and a mucopyocele of the sinus with osteomyelitis of the frontal bone 1.5 years postoperatively in another. No further early or long term sequelae originating from the sinus were seen.