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Laryngorhinootologie 2009; 88(9): 577-581
DOI: 10.1055/s-0029-1234068
Übersicht

© Georg Thieme Verlag KG Stuttgart · New York

Stirnhöhlenfraktur: aktuelle Kontroversen zur Therapie

Current Controversies in the Treatment of Frontal Sinus FracturesR. Litschel1 , A.-J. Tasman1
  • 1Hals-Nasen-Ohrenklinik, Kantonsspital St. Gallen, Schweiz
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Publication History

Publication Date:
26 August 2009 (online)

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Zusammenfassung

Die Therapie von Stirnhöhlenfrakturen war für lange Zeit von der Furcht vor Spätfolgen geprägt. Meningitis und Mukozelen sollten durch Kranialisation und Obliteration vorgebeugt werden. Diese Therapiekonzepte haben sich bis heute weitgehend unverändert als Therapiestandard gehalten, während die Möglichkeit der endoskopischen Nasennebenhöhlenchirurgie, die Qualität der Bildgebung und das chirurgische Instrumentarium sich in den vergangenen zwei Jahrzehnten erheblich verbesserten und verbreitet haben. Nun stellen die verfeinerten Techniken der endoskopischen Stirnhöhlenchirurgie, die Verbreitung von Navigationssystemen und die multiplanare hochauflösende Computertomografie, sowie neuere Daten über postoperative Komplikationen den Wert der Kranialisation und Obliteration als Standardtherapie zunehmend in Frage. Diese Übersicht fasst die aktuelle Diskussion in der Behandlung der Stirnhöhlenfrakturen anhand der aktuellen Literatur unter Berücksichtigung der vorhandenen Evidenz zusammen.

Abstract

Current Controversies in the Treatment of Frontal Sinus Fractures

The surgical treatment of frontal sinus fractures is foreshadowed by fears of late complications. Complications such as meningitis and mucoceles should be prevented by cranialization or obliteration of the frontal sinus. These procedures are still standard treatment despite of recent developments over the last two decades in endoscopic sinus surgery, in medical imaging and surgical instrumentation. Nowadays the role of cranialization and obliteration is challenged by refined endoscopic frontal sinus surgery techniques, the widely-used image-guided systems and the multiplanar high-resolution computed tomography along with new data about postoperative complications.

This overview summarizes the current literature, taking into account the existing evidence in the treatment of frontal sinus fractures.

Schlüsselwörter

Stirnhöhlenfraktur - Kranialisation - Obliteration - Mukozele - Osteosynthese - endoskopische Reposition - endoskopische Stirnhöhlenchirurgie

Key words

frontal sinus fracture - cranialization - obliteration - mucocele - osteosynthesis - endoscopic reposition - endoscopic frontal sinus surgery

Literatur

  • 1 Aitasalo KM, Peltola MJ. Bioactive glass hydroxyapatite in fronto-orbital defect reconstruction.  Plast Reconstr Surg. 2007;  120 ((7)) 1963-1972
    CrossrefPubMedGoogle Scholar
  • 2 Bell RB, Dierks EJ, Brar P, Potter JK, Potter BE. A protocol for the management of frontal sinus fractures emphasizing sinus preservation.  J Oral Maxillofac Surg. 2007;  65 ((5)) 825-839
    CrossrefPubMedGoogle Scholar
  • 3 Bergara AR, Itoiz AO. Present state of the surgical treatment of chronic frontal sinusitis.  AMA Arch Otolaryngol. 1955;  61 ((6)) 616-628
    CrossrefPubMedGoogle Scholar
  • 4 Chen KT, Chen CT, Mardini S, Tsay PK, Chen YR. Frontal sinus fractures: a treatment algorithm and assessment of outcomes based on 78 clinical cases.  Plast Reconstr Surg. 2006;  118 ((2)) 457-468
    CrossrefPubMedGoogle Scholar
  • 5 Davis WE. Growing obsolescence of the frontal sinus obliteration procedure.  Arch Otolaryngol Head Neck Surg. 2005;  131 ((6)) 532-533
    CrossrefPubMedGoogle Scholar
  • 6 Donald PJ. Frontal sinus ablation by cranialization. Report of 21 cases.  Arch Otolaryngol. 1982;  108 ((3)) 142-146
    Google Scholar
  • 7 Donald PJ, Bernstein L. Compound frontal sinus injuries with intracranial penetration.  Laryngoscope. 1978;  88 ((2 Pt 1)) 225-232
    Google Scholar
  • 8 Donald PJ, Ettin M. The safety of frontal sinus fat obliteration when sinus walls are missing.  Laryngoscope. 1986;  96 ((2)) 190-193
    Google Scholar
  • 9 El Khatib K, Danino A, Malka G. The frontal sinus: a culprit or a victim? A review of 40 cases.  J Craniomaxillofac Surg. 2004;  32 ((5)) 314-317
    CrossrefPubMedGoogle Scholar
  • 10 Goodale RL, Montgomery WW. Experiences with the osteoplastic anterior wall approach to the frontal sinus; case histories and recommendations.  AMA Arch Otolaryngol. 1958;  68 ((3)) 271-283
    PubMedGoogle Scholar
  • 11 Gossman DG, Archer SM, Arosarena O. Management of frontal sinus fractures: a review of 96 cases.  Laryngoscope. 2006;  116 ((8)) 1357-1362
    CrossrefPubMedGoogle Scholar
  • 12 Gurdjian ES, Shawan HK. Management of Skull Fracture involving the Frontal Sinus.  Ann Surg. 1932;  95 ((1)) 27-32
    PubMedGoogle Scholar
  • 13 Hueman K, Eller R. Reduction of anterior frontal sinus fracture involving the frontal outflow tract using balloon sinuplasty.  Otolaryngol Head Neck Surg. 2008;  139 ((1)) 170-171
    CrossrefPubMedGoogle Scholar
  • 14 Hybels RL, Newman MH. Posterior table fractures of the frontal sinus: I. An experimental study.  Laryngoscope. 1977;  87 ((2)) 171-179
    Google Scholar
  • 15 Kuhn FA. An integrated approach to frontal sinus surgery.  Otolaryngol Clin North Am. 2006;  39 ((3)) 437-461 , , viii
    CrossrefPubMedGoogle Scholar
  • 16 Lakhani RS, Shibuya TY, Mathog RH, Marks SC, Burgio DL, Yoo GH. Titanium mesh repair of the severely comminuted frontal sinus fracture.  Arch Otolaryngol Head Neck Surg. 2001;  127 ((6)) 665-669
    CrossrefPubMedGoogle Scholar
  • 17 Lanza DC. Frontal sinus obliteration is rarely indicated.  Arch Otolaryngol Head Neck Surg. 2005;  131 ((6)) 531-532
    CrossrefPubMedGoogle Scholar
  • 18 Luce EA. Frontal sinus fractures: guidelines to management.  Plast Reconstr Surg. 1987;  80 ((4)) 500-510
    Google Scholar
  • 19 Lynch R. The technique of a radical frontal sinus operation which has given me the best results.  Laryngoscope. 1921;  31 1
    Google Scholar
  • 20 Manolidis S, Hollier Jr LH. Management of frontal sinus fractures.  Plast Reconstr Surg. 2007;  120 ((7 Suppl 2)) S32-S48
    CrossrefPubMedGoogle Scholar
  • 21 Maturo SC, Weitzel EK, Cowhart J, Brennan J. Isolated posterior table frontal sinus fractures do not form mucoceles in a goat model.  Otolaryngol Head Neck Surg. 2008;  139 ((5)) 688-694
    CrossrefPubMedGoogle Scholar
  • 22 Mavili ME, Canter HI. Closed treatment of frontal sinus fracture with percutaneous screw reduction.  J Craniofac Surg. 2007;  18 ((2)) 415-419
    CrossrefPubMedGoogle Scholar
  • 23 Nahum AM. The biomechanics of maxillofacial trauma.  Clin Plast Surg. 1975;  2 ((1)) 59-64
    CrossrefPubMedGoogle Scholar
  • 24 Orlandi RR. Biomaterials for sinus implantation.  Curr Opin Otolaryngol Head Neck Surg. 2007;  15 ((1)) 44-47
    CrossrefPubMedGoogle Scholar
  • 25 Polley S. Technology Improves Management of Frontal Sinus Fractures.  ENToday. 2006;  1 ((5)) p 12-13
    PubMedGoogle Scholar
  • 26 Rodriguez ED, Stanwix MG, Nam AJ, St Hilaire H, Simmons OP, Christy MR, Grant MP, Manson PN. Twenty-six-year experience treating frontal sinus fractures: a novel algorithm based on anatomical fracture pattern and failure of conventional techniques.  Plast Reconstr Surg. 2008;  122 ((6)) 1850-1866
    CrossrefPubMedGoogle Scholar
  • 27 Rodriguez ED, Stanwix MG, Nam AJ, St Hilaire H, Simmons OP, Manson PN. Definitive treatment of persistent frontal sinus infections: elimination of dead space and sinonasal communication.  Plast Reconstr Surg. 2009;  123 ((3)) 957-967
    CrossrefPubMedGoogle Scholar
  • 28 Rontal ML. State of the art in craniomaxillofacial trauma: frontal sinus.  Curr Opin Otolaryngol Head Neck Surg. 2008;  16 ((4)) 381-386
    CrossrefPubMedGoogle Scholar
  • 29 Shumrick KA. Endoscopic management of frontal sinus fractures.  Otolaryngol Clin North Am. 2007;  40 ((2)) 329-336
    CrossrefPubMedGoogle Scholar
  • 30 Sillers MJ. Frontal sinus obliteration: an operation for the archives or modern armamentarium.  Arch Otolaryngol Head Neck Surg. 2005;  131 ((6)) 529-531
    CrossrefPubMedGoogle Scholar
  • 31 Smith TL, Han JK, Loehrl TA, Rhee JS. Endoscopic management of the frontal recess in frontal sinus fractures: a shift in the paradigm?.  Laryngoscope. 2002;  112 ((5)) 784-790
    CrossrefPubMedGoogle Scholar
  • 32 Stanley Jr RB. Fractures of the frontal sinus.  Clin Plast Surg. 1989;  16 ((1)) 115-123
    Google Scholar
  • 33 Strong EB. Endoscopic repair of anterior table frontal sinus fractures.  Facial Plast Surg. 2009;  25 ((1)) 43-48
    Article in Thieme ConnectPubMedGoogle Scholar
  • 34 Strong EB, Buchalter GM, Moulthrop TH. Endoscopic repair of isolated anterior table frontal sinus fractures.  Arch Facial Plast Surg. 2003;  5 ((6)) 514-521
    CrossrefPubMedGoogle Scholar
  • 35 Strong EB, Kellman RM. Endoscopic repair of anterior table – frontal sinus fractures.  Facial Plast Surg Clin North Am. 2006;  14 ((1)) 25-29
    CrossrefPubMedGoogle Scholar
  • 36 Strong EB, Pahlavan N, Saito D. Frontal sinus fractures: a 28-year retrospective review.  Otolaryngol Head Neck Surg. 2006;  135 ((5)) 774-779
    CrossrefPubMedGoogle Scholar
  • 37 Weber R, Draf W, Kratzsch B, Hosemann W, Schaefer SD. Modern concepts of frontal sinus surgery.  Laryngoscope. 2001;  111 ((1)) 137-146
    CrossrefPubMedGoogle Scholar
  • 38 Wilson BC, Davidson B, Corey JP, Haydon  3rd  RC. Comparison of complications following frontal sinus fractures managed with exploration with or without obliteration over 10 years.  Laryngoscope. 1988;  98 ((5)) 516-520
    Google Scholar
  • 39 Wolfe SA. Bioactive Glass Hydroxyapatite in Fronto-Orbital Defect Reconstruction.  Discussion. Plast Reconstr Surg. 2007;  120 ((7)) , Discussion 1973–1974
    PubMedGoogle Scholar
  • 40 Xie C, Mehendale N, Barrett D, Bui CJ, Metzinger SE. 30-year retrospective review of frontal sinus fractures: The Charity Hospital experience.  J Craniomaxillofac Trauma. 2000;  6 ((1)) 7-15 , discussion 16–8
    PubMedGoogle Scholar

Korrespondenzadresse

Ralph Litschel

Hals-Nasen-Ohrenklinik

Kantonsspital St. Gallen

Rorschacher Straße 95

9007 St. Gallen

Schweiz

Email: Ralph.Litschel@kssg.ch