Frontal sinus fracture: Difference between revisions

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****Through and through fx require sx to prevent pneumocephalus, CSF leak, infection
****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)
**If ant wall fx need CT to evaluate posterior wall (75% have both walls fractured)
==Differential Diagnosis==
{{Maxillofacial trauma DDX}}


==Management==
==Management==

Revision as of 08:29, 10 January 2015

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)

Differential Diagnosis

Maxillofacial Trauma

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

Source

Tintinalli's