Frontal sinus fracture - Revision history

ClaireLewis at 20:56, 30 September 2019

2019-09-30T20:56:39Z

← Older revision		Revision as of 20:56, 30 September 2019
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	**Rarely occurs in isolation, often associated wth intracranial injuries <ref>Strong EB. Frontal sinus fractures: a 28-year retrospective review. Otolaryngol Head Neck Surg. 2006;135(5):774-779</ref>		**Rarely occurs in isolation, often associated wth intracranial injuries <ref>Strong EB. Frontal sinus fractures: a 28-year retrospective review. Otolaryngol Head Neck Surg. 2006;135(5):774-779</ref>
	**Must rule-out [[TBI]], additional fracture, and [[cervical spine injury]]		**Must rule-out [[TBI]], additional fracture, and [[cervical spine injury]]
	*Long term sequelae include chronic sinusitis, mucocele, meningitis, brain abscess, frontal ~~osteomy- elitis~~, and CSF leak <ref>Bell RB. A protocol for the ~~manage- ment~~ of frontal sinus fractures emphasizing sinus preser- vation. J Oral Maxillofac Surg. 2007</ref>		*Long term sequelae include chronic [[sinusitis]], mucocele, [[meningitis]], [[brain abscess]], frontal [[osteomyelitis]], and CSF leak <ref>Bell RB. A protocol for the management of frontal sinus fractures emphasizing sinus preser- vation. J Oral Maxillofac Surg. 2007</ref>

	==Clinical Features==		==Clinical Features==
			*Assess sinus involvement:
			**Crepitus
			**Laceration over fracture site is typical

	==Differential Diagnosis==		==Differential Diagnosis==
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	==Evaluation==		==Evaluation==
	*Assess sinus involvement:
	**Crepitus
	**Laceration over fracture site is typical
	*Imaging		*Imaging
	**Head CT indicated if suspect fracture		**[[Head CT]] indicated if suspect fracture
	***Assess anterior and posterior tables		***Assess anterior and posterior tables
	****Through and through fracture require symptoms to prevent pneumocephalus, CSF leak, infection		****Through and through fracture require symptoms to prevent pneumocephalus, CSF leak, infection
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	==Management==		==Management==
	*Sinus involvement?		*Sinus involvement?
	**If yes then give 1st ~~gen~~ cephalosporin or [[amoxicillin clavulanate]]		**If yes then give 1st generation [[cephalosporin]] or [[amoxicillin clavulanate]]
	*Isolated anterior table fracture?		*Isolated anterior table fracture?
	**Discharge with facial surgeon follow up		**Discharge with facial surgeon follow up
	*Depressed fracture?		*Depressed fracture?
	**Admit for IV antibiotics and operative repair		**Admit for IV [[antibiotics]] and operative repair

	*~~Need~~ neurosurgery or ENT for posterior wall fracture since many need surgery and IV antibiotics		*Consult neurosurgery or ENT for posterior wall fracture since many need surgery and IV antibiotics

	==Disposition==		==Disposition==

Mholtz at 22:49, 9 May 2017

2017-05-09T22:49:30Z

← Older revision		Revision as of 22:49, 9 May 2017
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	**Must rule-out [[TBI]], additional fracture, and [[cervical spine injury]]		**Must rule-out [[TBI]], additional fracture, and [[cervical spine injury]]
	*Long term sequelae include chronic sinusitis, mucocele, meningitis, brain abscess, frontal osteomy- elitis, and CSF leak <ref>Bell RB. A protocol for the manage- ment of frontal sinus fractures emphasizing sinus preser- vation. J Oral Maxillofac Surg. 2007</ref>		*Long term sequelae include chronic sinusitis, mucocele, meningitis, brain abscess, frontal osteomy- elitis, and CSF leak <ref>Bell RB. A protocol for the manage- ment of frontal sinus fractures emphasizing sinus preser- vation. J Oral Maxillofac Surg. 2007</ref>

			==Clinical Features==


			==Differential Diagnosis==
			{{Maxillofacial trauma DDX}}

	==Evaluation==		==Evaluation==
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	****Through and through fracture require symptoms to prevent pneumocephalus, CSF leak, infection		****Through and through fracture require symptoms to prevent pneumocephalus, CSF leak, infection
	**If ant wall fracture need CT to evaluate posterior wall (75% have both walls fractured)		**If ant wall fracture need CT to evaluate posterior wall (75% have both walls fractured)

	~~==Differential Diagnosis==~~
	~~{{Maxillofacial trauma DDX}}~~

	==Management==		==Management==
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	*Need neurosurgery or ENT for posterior wall fracture since many need surgery and IV antibiotics		*Need neurosurgery or ENT for posterior wall fracture since many need surgery and IV antibiotics

			==Disposition==


	==See Also==		==See Also==
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	==References==		==References==
	<references/>		<references/>


	[[Category:ENT]]		[[Category:ENT]]
	[[Category:Orthopedics]]		[[Category:Orthopedics]]
	[[Category:Trauma]]		[[Category:Trauma]]

Lisayee25: /* Background */

2017-05-08T07:08:41Z

Background

← Older revision		Revision as of 07:08, 8 May 2017
Line 3:		Line 3:
	**Rarely occurs in isolation, often associated wth intracranial injuries <ref>Strong EB. Frontal sinus fractures: a 28-year retrospective review. Otolaryngol Head Neck Surg. 2006;135(5):774-779</ref>		**Rarely occurs in isolation, often associated wth intracranial injuries <ref>Strong EB. Frontal sinus fractures: a 28-year retrospective review. Otolaryngol Head Neck Surg. 2006;135(5):774-779</ref>
	**Must rule-out [[TBI]], additional fracture, and [[cervical spine injury]]		**Must rule-out [[TBI]], additional fracture, and [[cervical spine injury]]
			*Long term sequelae include chronic sinusitis, mucocele, meningitis, brain abscess, frontal osteomy- elitis, and CSF leak <ref>Bell RB. A protocol for the manage- ment of frontal sinus fractures emphasizing sinus preser- vation. J Oral Maxillofac Surg. 2007</ref>

	==Evaluation==		==Evaluation==

Lisayee25: /* Background */

2017-05-08T07:06:30Z

Background

← Older revision		Revision as of 07:06, 8 May 2017
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	==Background==		==Background==
	*Requires high-energy		*Requires high-energy
			**Rarely occurs in isolation, often associated wth intracranial injuries <ref>Strong EB. Frontal sinus fractures: a 28-year retrospective review. Otolaryngol Head Neck Surg. 2006;135(5):774-779</ref>
	**Must rule-out [[TBI]], additional fracture, and [[cervical spine injury]]		**Must rule-out [[TBI]], additional fracture, and [[cervical spine injury]]

Neil.m.young: Text replacement - "==Diagnosis==" to "==Evaluation=="

2016-07-22T04:23:58Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 04:23, 22 July 2016
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	**Must rule-out [[TBI]], additional fracture, and [[cervical spine injury]]		**Must rule-out [[TBI]], additional fracture, and [[cervical spine injury]]

	==~~Diagnosis~~==		==Evaluation==
	*Assess sinus involvement:		*Assess sinus involvement:
	**Crepitus		**Crepitus

ClaireLewis: /* Management */

2016-07-13T23:38:01Z

Management

← Older revision		Revision as of 23:38, 13 July 2016
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	==Management==		==Management==
	*Sinus involvement?		*Sinus involvement?
	**If yes then give 1st gen cephalosporin or amoxicillin clavulanate		**If yes then give 1st gen cephalosporin or [[amoxicillin clavulanate]]
	*Isolated anterior table fracture?		*Isolated anterior table fracture?
	**~~D/C w/~~ facial surgeon follow up		**Discharge with facial surgeon follow up
	*~~Depresed~~ fracture?		*Depressed fracture?
	**Admit for IV ~~abx~~ and operative repair		**Admit for IV antibiotics and operative repair

	*Need ~~neurosurg~~ or ENT for posterior wall fracture since many need surgery and IV ~~abx~~		*Need neurosurgery or ENT for posterior wall fracture since many need surgery and IV antibiotics

	==See Also==		==See Also==

ClaireLewis: /* Background */

2016-07-13T23:37:13Z

Background

← Older revision		Revision as of 23:37, 13 July 2016
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	==Background==		==Background==
	*Requires high-energy		*Requires high-energy
	**Must rule-out TBI, additional fracture, and cervical spine injury		**Must rule-out [[TBI]], additional fracture, and [[cervical spine injury]]

	==Diagnosis==		==Diagnosis==

Rossdonaldson1: Text replacement - "f/u" to "follow up"

2016-07-13T02:09:09Z

Text replacement - "f/u" to "follow up"

← Older revision		Revision as of 02:09, 13 July 2016
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	**If yes then give 1st gen cephalosporin or amoxicillin clavulanate		**If yes then give 1st gen cephalosporin or amoxicillin clavulanate
	*Isolated anterior table fracture?		*Isolated anterior table fracture?
	**D/C w/ facial surgeon ~~f/u~~		**D/C w/ facial surgeon follow up
	*Depresed fracture?		*Depresed fracture?
	**Admit for IV abx and operative repair		**Admit for IV abx and operative repair

Rossdonaldson1: Text replacement - "fx" to "fracture"

2016-07-08T10:35:25Z

Text replacement - "fx" to "fracture"

← Older revision		Revision as of 10:35, 8 July 2016
Line 1:		Line 1:
	==Background==		==Background==
	*Requires high-energy		*Requires high-energy
	**Must rule-out TBI, additional fx, and cervical spine injury		**Must rule-out TBI, additional fracture, and cervical spine injury

	==Diagnosis==		==Diagnosis==
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	*Sinus involvement?		*Sinus involvement?
	**If yes then give 1st gen cephalosporin or amoxicillin clavulanate		**If yes then give 1st gen cephalosporin or amoxicillin clavulanate
	*Isolated anterior table fx?		*Isolated anterior table fracture?
	**D/C w/ facial surgeon f/u		**D/C w/ facial surgeon f/u
	*Depresed fx?		*Depresed fracture?
	**Admit for IV abx and operative repair		**Admit for IV abx and operative repair

Neil.m.young: Text replacement - "sx " to "symptoms "

2016-07-06T09:52:58Z

Text replacement - "sx " to "symptoms "

← Older revision		Revision as of 09:52, 6 July 2016
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	**Head CT indicated if suspect fracture		**Head CT indicated if suspect fracture
	***Assess anterior and posterior tables		***Assess anterior and posterior tables
	****Through and through fracture require sx to prevent pneumocephalus, CSF leak, infection		****Through and through fracture require symptoms to prevent pneumocephalus, CSF leak, infection
	**If ant wall fracture need CT to evaluate posterior wall (75% have both walls fractured)		**If ant wall fracture need CT to evaluate posterior wall (75% have both walls fractured)