Frontal Sinus Fracture Management and Surgical Approaches
Summary
Frontal sinus fractures encompass a spectrum of injury to the anterior and posterior walls of the frontal sinus, often with involvement of the nasofrontal duct. High-velocity impacts may produce isolated anterior-table fractures or complex injuries that jeopardise intracranial integrity and sinonasal function. Management objectives include restoration of facial contour, preservation of mucociliary drainage, prevention of cerebrospinal fluid leak and avoidance of intracranial infection. Treatment spans conservative observation for minimally displaced anterior-table fractures through to open reduction and internal fixation for unstable configurations, endoscopic repair of ductal injuries, sinus obliteration and cranialisation for extensive posterior-table compromise. Choice of approach is guided by fracture morphology, ductal patency, patient comorbidities and aesthetic considerations, emphasising multidisciplinary collaboration among otolaryngologists, neurosurgeons and maxillofacial surgeons.
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Frontal Sinus Fracture Management and Surgical Approaches publication trend
The graph below shows the total number of articles in frontal sinus fracture management and surgical approaches across all publications each year (not limited to Nature Index journals).
Technical terms
Cranialisation: surgical removal of the posterior sinus wall and incorporation of the sinus cavity into the intracranial space to eliminate mucosal remnants and prevent infection.
Sinus obliteration: filling of the frontal sinus with autologous or allogeneic material to seal the cavity and halt mucocele formation.
Open reduction and internal fixation (ORIF): conventional surgical realignment of bone fragments followed by stabilisation with plates or screws.
Nasofrontal duct: narrow channel connecting the frontal sinus to the nasal cavity, whose patency is critical for drainage and mucociliary clearance.
Mucocele: expansile cystic lesion arising from obstruction of sinus ostia, leading to mucous accumulation and bone erosion.
References
- Management of frontal sinus trauma: a retrospective study of surgical interventions and complications. Maxillofacial Plastic and Reconstructive Surgery (2024).
- Trauma of the Frontal Region Is Influenced by the Volume of Frontal Sinuses. A Finite Element Study. Frontiers in Physiology (2017).
- Management of Aesthetic and Functional Deficits in Frontal Bone Trauma. Medicina (2022).
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