Frontal sinus fracture: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "Tintinalli's" to "") |
Neil.m.young (talk | contribs) (Text replacement - "fx " to "fracture ") |
||
| Line 10: | Line 10: | ||
**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 | ****Through and through fracture require sx to prevent pneumocephalus, CSF leak, infection | ||
**If ant wall | **If ant wall fracture need CT to evaluate posterior wall (75% have both walls fractured) | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 24: | Line 24: | ||
**Admit for IV abx and operative repair | **Admit for IV abx and operative repair | ||
*Need neurosurg or ENT for posterior wall | *Need neurosurg or ENT for posterior wall fracture since many need surgery and IV abx | ||
==See Also== | ==See Also== | ||
Revision as of 00:17, 3 July 2016
Background
- Requires high-energy
- Must rule-out TBI, additional fx, and cervical spine injury
Diagnosis
- 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 sx to prevent pneumocephalus, CSF leak, infection
- Assess anterior and posterior tables
- If ant wall fracture need CT to evaluate posterior wall (75% have both walls fractured)
- Head CT indicated if suspect fracture
Differential Diagnosis
Maxillofacial Trauma
- Ears
- Nose
- Oral
- Other face
- Zygomatic arch fracture
- Zygomaticomaxillary (tripod) fracture
- Related
Management
- Sinus involvement?
- If yes then give 1st gen cephalosporin or amoxicillin clavulanate
- Isolated anterior table fx?
- D/C w/ facial surgeon f/u
- Depresed fx?
- Admit for IV abx and operative repair
- Need neurosurg or ENT for posterior wall fracture since many need surgery and IV abx