Frontal sinus fracture

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
  • If ant wall fx need CT to evaluate posterior wall (75% have both walls fractured)

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

See Also

• Maxillofacial Trauma

Source

Tintinalli's