Frontal Sinus Fractures

8.2.1 Discuss the physiology of the nasofrontal duct.

8.2.2 How would you assess the viability of the nasofrontal duct in frontal sinus fracture?

8.2.3 List the acute and late complications following frontal sinus fracture? What is the most common late complication and how would you manage it? Could it have been avoided?

Manolidis S, Hollier LH Jr. Management of frontal sinus fractures. Plast Reconstr Surg. 2007 Dec;120(7 Suppl 2):32S-48S. PMID:18090727

8.2.4 An 18-year-old man has a displaced fracture of the anterior table of the frontal sinus. Discuss the various available options for fixation of this fracture.

Rontal ML. State of the art in craniomaxillofacial trauma: frontal sinus. Curr Opin Otolaryngol Head Neck Surg. 2008 Aug;16(4):381-Review. PMID:18626259

8.2.5 Educate the group on endoscopic repair of isolated anterior table frontal sinus fractures.

Strong EB, Buchalter GM, Moulthrop TH. Endoscopic repair of isolated anterior table frontal sinus fractures. Arch Facial Plast Surg. 2003 Nov-Dec;5(6):514-21. PMID:14623691

Strong EB. Endoscopic repair of anterior table frontal sinus fractures. Facial Plast Surg. 2009 Feb;25(1):43-Epub 2009 Feb 10. PMID:19206028

8.2.6 A 25-year-old man sustains a fracture of the frontal sinus in a motor vehicle collision. CT scans reveal an anterior table fracture that involves the nasofrontal duct. Discuss the options.

Smith TL, Han JK, Loehrl TA, Rhee JS. Endoscopic management of the frontal recess in frontal sinus fractures: a shift in the paradigm? Laryngoscope. 2002 May;112(5):784-90. PMID:12150607

8.2.7 You are called to the trauma bay to evaluate a 30-year-old female with a frontal sinus fracture. A CT scan shows a comminuted fracture of the anterior table and a linear non-displaced fracture of the posterior table. There is no evidence of cerebrospinal fluid leak. How would you manage this patient?

8.2.8 When would you obliterate a frontal sinus and what would you use?

Parhiscar A, Har-El G. Frontal sinus obliteration with the pericranial flap. Otolaryngol Head Neck Surg. 2001 Mar;124(3):304-7. PMID:11240996

Snyderman CH, Scioscia K, Carrau RL, Weissman JL. Hydroxyapatite: an alternative method of frontal sinus obliteration. Otolaryngol Clin North Am. 2001 Feb;34(1):179-91. PMID:11344072

Petruzzelli GJ, Stankiewicz JA. Frontal sinus obliteration with hydroxyapatite cement. Laryngoscope. 2002 Jan;112(1):32-6. PMID:11802035

8.2.9 Discuss the management of posterior table fractures with a CSF leak.

Sakas DE et al. Compound anterior cranial base fractures: classification using computerized tomography scanning as a basis for selection of patients for dural repair. J Neurosurg. 1998 Mar;88(3):471-7. PMID:9488300

8.2.10 How would you manage the frontal sinus mucosa during an obliteration or cranialization procedure? Support your answer with data.