Frontal sinus fracture: Difference between revisions

Revision as of 07:08, 8 May 2017

Requires high-energy
- Rarely occurs in isolation, often associated wth intracranial injuries ^[1]
- 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 ^[2]

Assess sinus involvement:
- Crepitus
- Laceration over fracture site is typical
Imaging
- Head CT indicated if suspect fracture
  - Assess anterior and posterior tables
    - 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)

Sinus involvement?
- If yes then give 1st gen cephalosporin or amoxicillin clavulanate
Isolated anterior table fracture?
- Discharge with facial surgeon follow up
Depressed fracture?
- Admit for IV antibiotics and operative repair

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

↑ Strong EB. Frontal sinus fractures: a 28-year retrospective review. Otolaryngol Head Neck Surg. 2006;135(5):774-779
↑ Bell RB. A protocol for the manage- ment of frontal sinus fractures emphasizing sinus preser- vation. J Oral Maxillofac Surg. 2007

Authors:

@@ 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>
 **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==