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Otolaryngology (ENT)9 papers

Fracture of frontal sinus

Last edited: 4/16/2026

Overview

Frontal sinus fractures involve injuries to the frontal sinus, often resulting from blunt trauma to the forehead. Management varies based on fracture severity, involved structures, and patient-specific factors. 1

Diagnosis

  • Clinical history and physical examination focusing on trauma mechanism and associated symptoms.
  • Imaging: CT scan with thin cuts through the sinuses is essential for detailed fracture assessment.
  • Grading systems often consider fracture location (anterior vs. posterior table), involvement of nasofrontal duct, and associated injuries. 1

    • Management

  • Conservative Management: Recommended for less severe anterior table fractures with no complications.
  • Minimally Invasive Surgery: Increasingly favored for anterior table fractures to preserve sinus integrity and improve aesthetics.
  • Sinus-Sparing Techniques: Preferred for posterior wall fractures and nasofrontal duct involvement when feasible.
  • Obliteration/Cranialization: Considered for complex fractures where sinus preservation is not feasible, based on patient-specific factors. 1

    • Special Populations

  • Pediatrics: Specific considerations for growth and development; conservative approaches are often prioritized. 1
  • Elderly: Increased risk of comorbidities; management tailored to overall health status and fracture complexity. 1
  • Comorbidities: Presence of other injuries or systemic conditions influences surgical versus conservative treatment decisions. 1

    • Key Recommendations

  • Select conservative management for anterior table fractures without significant complications (Evidence: Moderate 1).
  • Employ minimally invasive techniques to preserve sinus function and enhance aesthetic outcomes (Evidence: Moderate 1).
  • Consider sinus obliteration or cranialization for complex posterior wall fractures and cases where preservation is not feasible (Evidence: Expert opinion 1).

    • References

    1 Chouake RJ, Miles BA. Current opinion in otolaryngology and head and neck surgery: frontal sinus fractures. Current opinion in otolaryngology & head and neck surgery 2017. link

    Original source

    1. [1]
      Current opinion in otolaryngology and head and neck surgery: frontal sinus fractures. — Chouake RJ, Miles BA Current opinion in otolaryngology & head and neck surgery (2017)
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