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Seminars in Plastic Surgery Nov 2021Management of frontal sinus fractures is controversial with no universally accepted treatment protocol. Goals of management are to correct aesthetic deformity, preserve... (Review)
Review
Management of frontal sinus fractures is controversial with no universally accepted treatment protocol. Goals of management are to correct aesthetic deformity, preserve sinus function when it is deemed salvageable, prevent sequela related to the injury, and minimize complications associated with intervention. Studies suggest that frontal sinus injuries, including disruption of the nasofrontal outflow tract (NFOT), can be managed nonoperatively in many cases. Advances in the utilization of endoscopic techniques have led to an evolution in management that reduces the need for open procedures, which have increased morbidity compared with endoscopic approaches. We employ a minimally disruptive protocol that treats the majority of fractures nonoperatively with serial clinical and radiographic examinations to assess for sinus aeration. Surgical intervention is reserved for the most severely displaced and comminuted posterior table fractures and unsalvageable NFOTs utilizing endoscopic approaches whenever possible.
PubMed: 34819810
DOI: 10.1055/s-0041-1736325 -
Seminars in Plastic Surgery May 2017The frontal bone serves a protective role, representing the transition between the facial skeleton and the cranium. Within its enclosure, the frontal sinus lies adjacent... (Review)
Review
The frontal bone serves a protective role, representing the transition between the facial skeleton and the cranium. Within its enclosure, the frontal sinus lies adjacent to many important intracranial structures, and injury to this region has severe complications if not properly managed. Historically, the goals of frontal sinus fracture management have been to best prevent intracranial complications with invasive procedures, but a recent shift favoring conservative management now aims to preserve the form and function of the frontal sinus and its outflow tract. With the advancement of endoscopic techniques and the development of new technologies, many alternatives to aggressive surgical management are available.
PubMed: 28496387
DOI: 10.1055/s-0037-1601371 -
Plastic and Reconstructive Surgery.... Apr 2022Despite significant advances in the management of frontal sinus fractures, there is still a paucity of large-cohort data, and a comprehensive synthesis of the current... (Review)
Review
BACKGROUND
Despite significant advances in the management of frontal sinus fractures, there is still a paucity of large-cohort data, and a comprehensive synthesis of the current literature is warranted. The purpose of this study was to present an evidence-based overview of frontal sinus fracture management and outcomes.
METHODS
A comprehensive literature search of PubMed and MEDLINE was conducted for studies published between 1992 and 2020 investigating frontal sinus fractures. Data on fracture type, intervention, and outcome measurements were reported.
RESULTS
In total, 456 articles were identified, of which 53 met our criteria and were included in our analysis. No statistically significant difference in mechanism of injury, fracture pattern, form of management, or total complication rate was identified. We found a statistically significant increase in complication rates in patients with nasofrontal outflow tract injury compared with those without.
CONCLUSIONS
Frontal sinus fracture management is a challenging clinical situation, with no widely accepted algorithm to guide appropriate management. Thorough clinical assessment of the fracture pattern and associated injuries can facilitate clinical decision-making.
PubMed: 35450261
DOI: 10.1097/GOX.0000000000004266 -
Ear, Nose, & Throat Journal Sep 2021Pott's puffy tumor is a potential complication of acute frontal sinusitis, characterized by subperiosteal abscess and osteomyelitis of the frontal bone. It can be...
Pott's puffy tumor is a potential complication of acute frontal sinusitis, characterized by subperiosteal abscess and osteomyelitis of the frontal bone. It can be managed with a combination of open and endoscopic sinus surgery and intravenous antibiotic therapy. In the current report, a 15-year-old male presented with a classic case of Pott's puffy tumor which was managed with bilateral ethmoidectomies, frontal sinusotomies, and frontal sinus trephination, resulting in discharge on intravenous antibiotic therapy and subsequent complete resolution of symptoms.
Topics: Abscess; Adolescent; Anti-Bacterial Agents; Edema; Erythema; Ethmoid Sinus; Frontal Bone; Frontal Sinus; Humans; Male; Pott Puffy Tumor; Trephining
PubMed: 34414793
DOI: 10.1177/01455613211039031 -
Craniomaxillofacial Trauma &... Sep 2019Frontal sinus fractures are relatively rare maxillofacial injuries (only 5-15% of all facial fractures). The appropriate management of frontal sinus fracture and...
Frontal sinus fractures are relatively rare maxillofacial injuries (only 5-15% of all facial fractures). The appropriate management of frontal sinus fracture and associated pathology is controversial. Diagnosis and treatment of frontal sinus fractures has improved with the advances of high-resolution computed tomography technology. Treatment of frontal sinus fractures depends on several factors, including contour deformity of anterior table; the presence of CSF leak or air-fluid level in the sinus, likelihood of nasofrontal duct obstruction, and degree of displacement of posterior table. Nasofrontal duct patency should be checked if fracture pattern is highly suspicious of ductal injury. Cranialization is performed in cases of severely comminuted posterior wall fracture. Long-term complication of frontal sinus fracture can occur up to 10 years after initial injury or intervention; so, judicious long-term follow-up is warranted. This article presents the management and complications of frontal sinus fractures.
PubMed: 31428249
DOI: 10.1055/s-0038-1675560 -
European Annals of Otorhinolaryngology,... Jun 2018Nasal sinus schwannomas are rare tumors, particularly in the frontal sinus.
INTRODUCTION
Nasal sinus schwannomas are rare tumors, particularly in the frontal sinus.
CASE REPORT
The authors report the case of a woman with left frontal sinus schwannoma discovered in a context of frontal sinusitis with orbital and ocular complications. The surgical procedure consisted of endonasal tumor resection and external drainage.
DISCUSSION
The pathogenesis of frontal sinus schwannomas remains unclear. These tumors can present with a wide range of clinical and radiological signs, making them difficult to diagnosis. Surgical resection of these tumors is also complex.
Topics: Female; Frontal Sinus; Humans; Middle Aged; Neurilemmoma; Paranasal Sinus Neoplasms
PubMed: 29703708
DOI: 10.1016/j.anorl.2018.03.001 -
Craniomaxillofacial Trauma &... Jun 2019Frontal sinus fractures are an uncommon injury of the maxillofacial skeleton, and account for 5-15% of all maxillofacial fractures. As the force of impact increases,... (Review)
Review
Frontal sinus fractures are an uncommon injury of the maxillofacial skeleton, and account for 5-15% of all maxillofacial fractures. As the force of impact increases, fractures may extend beyond the anterior table to involve adjacent skull, posterior table and frontal sinus outflow tract (FSOT). Fractures at these subsites should be evaluated independently to assess the need for and type of operative intervention. Historically, these fractures were managed aggressively with open techniques resulting in obliteration or cranialization. With significant injuries, these approaches are still indispensable. However, the treatment of frontal sinus fractures has changed dramatically over the past half-century, and recent case series have demonstrated favorable outcomes with conservative management. Concurrently, there has been an increasing role of minimally invasive endoscopic techniques, both for primary and expectant management, with a focus on sinus preservation. Here, we review the diagnosis and management of frontal sinus fractures, with an emphasis on subsite evaluation. Following a detailed assessment, an appropriate treatment strategy is selected from a variety of open and minimally invasive approaches available in the surgeon's armamentarium.
PubMed: 31073357
DOI: 10.1055/s-0039-1678660 -
Journal of Cranio-maxillo-facial... Sep 2022The aim of this study was to review different approaches and outcomes in the management of post-COVID-19 frontal sinus fungal osteomyelitis. The study included 19... (Review)
Review
The aim of this study was to review different approaches and outcomes in the management of post-COVID-19 frontal sinus fungal osteomyelitis. The study included 19 patients with frontal sinus fungal osteomyelitis. The main line of treatment was surgical debridement (sequestrectomy). Approaches included combined external and endoscopic approaches (n = 15) and pure endoscopic approaches (n = 4) according to the extent and accessibility of the sequestrum. Postoperative healing was satisfactory in all patients. All patients returned to their normal daily activity within 4-6 weeks, without residual or recurrent frontal sinus infection, osteomyelitis or need for revision procedures. Within the limitation of this case series, it seems that there is no need to adopt a new therapy regimen for treatment of frontal sinus fungal osteomyelitis because the conventional and well-known treatment approach combining surgery and antifungal drugs seems to work well. However, early, and adequate debridement and sequestrectomy is crucial. Furthermore, an open approach may be required according to the extent of osteomyelitis.
Topics: Antifungal Agents; COVID-19; Endoscopy; Frontal Sinus; Frontal Sinusitis; Humans; Osteomyelitis
PubMed: 35961885
DOI: 10.1016/j.jcms.2022.07.010 -
European Oral Research Sep 2022The aim of this retrospective research is to compare frontal sinus dimensions in skeletal Class I, skeletal Class II, and skeletal Class III individuals and to evaluate...
PURPOSE
The aim of this retrospective research is to compare frontal sinus dimensions in skeletal Class I, skeletal Class II, and skeletal Class III individuals and to evaluate the relationship of these dimensions with anterior skull base length and some cephalometric values.
MATERIALS AND METHODS
In this research, we used lateral cephalometric radiographs of 60 people aged 17 to 25. In individuals with skeletal Class I malocclusion, skeletal Class II malocclusion due to mandibular insufficiency, and skeletal Class III malocclusion due to mandibular excess, measurements of frontal sinus length and height as well as S-N, Co-A and Co- Gn lengths, ANB0, FMA0, SN-GoGn0 angles values were performed. The length between the highest point and the lowest point of the frontal sinus was calculated as the height of the frontal sinus, and the length between the most anterior and the most posterior points of the frontal sinus was calculated as the length of the frontal sinus.
RESULTS
The frontal sinus length and height were found to be higher in skeletal Class III individuals than in skeletal Class I and skeletal Class II individuals, however, there was no significant difference between skeletal Class I and Class II individuals.
CONCLUSION
The increase in frontal sinus height and length correlated positively with the decrease in the ANB angle and the increase in the SN and Co-Gn lengths. The dimensions of the frontal sinus may be an indicator for the remaining mandibular growth potential.
PubMed: 36660223
DOI: 10.26650/eor.2022938080