Technological advances in recent years are creating a shift in the paradigm regarding the management of frontal sinus fractures. These advances have made it possible for some patients to be managed in a more conservative and expectant manner, reducing the chance of morbidity and long-term sequelae, and increasing the chance of a more desirable cosmetic outcome.
Explore this issue:July 2006
Frontal sinus fractures are not at all uncommon, accounting for 5% to 12% of all facial fractures, reported frontal sinus fracture expert E. Bradley Strong, MD, in an eMedicine article (available online at www.emedicine.com/ent/topic419.htm ). How to best treat frontal sinus fractures has been debated for years; however, the management of these injuries has become highly advanced in recent years through the use of endoscopic procedures, CT and computer enhancement, and improved radiographic technology.
Initial Trauma Assessment
Because significant force is required to fracture the frontal sinus, other life-threatening injuries may exist, wrote Dale H. Rice, MD, in an article titled Management of frontal sinus fractures (Curr Opin Otolaryngol Head Neck Surg. 2004;12:46-48). Serious injuries are associated with frontal sinus fractures in 75% of cases. The first consideration is to identify and treat life threats and accompanying injuries that may cause significant morbidity, writes Dr. Strong. As always, airway, circulation, and breathing must be assessed and stabilized if necessary. Stabilization of the cervical spine must be maintained until related injuries are ruled out. A thorough head and neck examination must be performed to evaluate injuries to the brain, spine, and orbits.