Frontal sinus fracture: Difference between revisions
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Revision as of 03:50, 28 June 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 fx require sx to prevent pneumocephalus, CSF leak, infection
- Assess anterior and posterior tables
- If ant wall fx 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 fx since many need surgery and IV abx