Cranial Maxillofac Trauma Reconstruction 2019; 12(02): 085-094
DOI: 10.1055/s-0039-1678660
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Frontal Sinus Fractures: Evolving Clinical Considerations and Surgical Approaches

Mark A. Arnold
1  Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, New York
Sherard A. Tatum III
1  Department of Otolaryngology, SUNY Upstate Medical University, Syracuse, New York
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30. September 2018

29. Dezember 2018

04. Februar 2019 (online)


Frontal sinus fractures are an uncommon injury of the maxillofacial skeleton, and account for 5–15% of all maxillofacial fractures. As the force of impact increases, fractures may extend beyond the anterior table to involve adjacent skull, posterior table and frontal sinus outflow tract (FSOT). Fractures at these subsites should be evaluated independently to assess the need for and type of operative intervention. Historically, these fractures were managed aggressively with open techniques resulting in obliteration or cranialization. With significant injuries, these approaches are still indispensable. However, the treatment of frontal sinus fractures has changed dramatically over the past half-century, and recent case series have demonstrated favorable outcomes with conservative management. Concurrently, there has been an increasing role of minimally invasive endoscopic techniques, both for primary and expectant management, with a focus on sinus preservation. Here, we review the diagnosis and management of frontal sinus fractures, with an emphasis on subsite evaluation. Following a detailed assessment, an appropriate treatment strategy is selected from a variety of open and minimally invasive approaches available in the surgeon's armamentarium.