Tarek Abdelzaher Emara1, Ismail Seddik Elnashar2, Tharwat Abdelzaher Omara3, Waleed Mohamed Basha2, Ahmad Mohamad Anany2. 1. Otolaryngology Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt. Electronic address: tarek.emara@yahoo.com. 2. Otolaryngology Head and Neck Surgery Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt. 3. Oral and Maxillofacial Surgery Department (Head: Consultant Abdelzaher Omara, D.M.D), Al-Ahrar General Hospital, Zagazig, Egypt.
Abstract
OBJECTIVE: The description of a new approach for the management of patients with frontal sinus fractures and associated obstruction of the frontal outflow tract to, restore sinus function and avoiding sinus obliteration. SUBJECTS AND METHODS: In a prospective study, 21 patients with anterior wall frontal sinus fractures associated with potential obstruction of the frontal outflow tract, underwent rigid internal fixation and intraoperative guarded nasal endoscopic debridement of any bony spicules and lacerated mucosa to clear the frontal recess. Patients were followed up clinically and radiologically by CT to assess the status of the frontal sinus and to detect any manifestations of frontal sinusitis or any other complications. RESULTS: Seventeen patients completed the postoperative follow-up while four patients were excluded from the study. Postoperative follow-up ranged from 6 to 34 months with a mean of 20 months. All patients had associated craniofacial fractures. Follow-up CT scans showed complete restoration of frontal sinus ventilation and mucociliary clearance for 13 patients. Four patients showed frontal sinus mild mucosal thickening without signs of chronic sinusitis. CONCLUSION: Patients with anterior wall frontal sinus fractures associated with frontal sinus outflow tract obstruction could be successfully managed with rigid internal fixation and intraoperative guarded endoscopic debridement of any bony spicules and lacerated mucosa to clear the frontal recess. This type of management could increase the chance of frontal sinus preservation and decrease the need for frontal sinus obliteration for similar patients.
OBJECTIVE: The description of a new approach for the management of patients with frontal sinus fractures and associated obstruction of the frontal outflow tract to, restore sinus function and avoiding sinus obliteration. SUBJECTS AND METHODS: In a prospective study, 21 patients with anterior wall frontal sinus fractures associated with potential obstruction of the frontal outflow tract, underwent rigid internal fixation and intraoperative guarded nasal endoscopic debridement of any bony spicules and lacerated mucosa to clear the frontal recess. Patients were followed up clinically and radiologically by CT to assess the status of the frontal sinus and to detect any manifestations of frontal sinusitis or any other complications. RESULTS: Seventeen patients completed the postoperative follow-up while four patients were excluded from the study. Postoperative follow-up ranged from 6 to 34 months with a mean of 20 months. All patients had associated craniofacial fractures. Follow-up CT scans showed complete restoration of frontal sinus ventilation and mucociliary clearance for 13 patients. Four patients showed frontal sinus mild mucosal thickening without signs of chronic sinusitis. CONCLUSION:Patients with anterior wall frontal sinus fractures associated with frontal sinus outflow tract obstruction could be successfully managed with rigid internal fixation and intraoperative guarded endoscopic debridement of any bony spicules and lacerated mucosa to clear the frontal recess. This type of management could increase the chance of frontal sinus preservation and decrease the need for frontal sinus obliteration for similar patients.
Authors: F M Crocetta; P Farneti; G Sollini; A Castellucci; A Ghidini; M C Spinosi; I J Fernandez; M Zoli; D Mazzatenta; E Pasquini Journal: Eur Arch Otorhinolaryngol Date: 2020-09-03 Impact factor: 2.503
Authors: Kevin J Choi; Bora Chang; Charles R Woodard; David B Powers; Jeffrey R Marcus; Liana Puscas Journal: Craniomaxillofac Trauma Reconstr Date: 2017-02-03
Authors: Christopher D Lopez; Ricardo Rodriguez Colon; Joseph Lopez; Paul N Manson; Eduardo D Rodriguez Journal: Plast Reconstr Surg Glob Open Date: 2022-04-18