Frontal sinus fracture: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "sx " to "symptoms ") |
(Text replacement - "fx" to "fracture") |
||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Requires high-energy | *Requires high-energy | ||
**Must rule-out TBI, additional | **Must rule-out TBI, additional fracture, and cervical spine injury | ||
==Diagnosis== | ==Diagnosis== | ||
| Line 19: | Line 19: | ||
*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 | *Isolated anterior table fracture? | ||
**D/C w/ facial surgeon f/u | **D/C w/ facial surgeon f/u | ||
*Depresed | *Depresed fracture? | ||
**Admit for IV abx and operative repair | **Admit for IV abx and operative repair | ||
Revision as of 10:35, 8 July 2016
Background
- Requires high-energy
- Must rule-out TBI, additional fracture, 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 symptoms 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 fracture?
- D/C w/ facial surgeon f/u
- Depresed fracture?
- Admit for IV abx and operative repair
- Need neurosurg or ENT for posterior wall fracture since many need surgery and IV abx