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KMID : 0390320080180020522
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Chungbuk Medical Journal
2008 Volume.18 No. 2 p.522 ~ p.528
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Management of frontal sinus fracture involving the nasofrontal duct
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Yeon Je-Yeob
Shim Woo-Sub
Yoo Seung-Do
Choi Ji-Chul
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Abstract
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Purpose: The patency of nasofrontal duct is an important factor to decide the strategy for the management of frontal sinus fracture. The aims of this study was to compare the complication rate between three different management methods in frontal sinus fracture with nasofrontal duct involvement and to suggest a new algorithm for the management of frontal sinus fracture.
Materials and Methods : The authors conducted retrospective study with medical records of 21 patients who had undergone surgical procedures for frontal sinus fracture from January 1996 to May 2006, who have been followed up for 6 months at least. Eleven cases of them had undergone sinus preserving surgery and 10 patients had undergone frontal sinus obliteration. We compared the incidence of complications such as mucocele, meningitis, brain abscess that were confirmed by history taking, physical exam and radiologic study.
Results : We preserved the sinus when the reconstruction of nasofrontal duct was possible and otherwise we obliterated the sinus. There was no patient who complained headache in sinus obliteration group. Whereas 3 patients complained chronic headache in sinus preserving group but none of them developed complications such as mucocele, meningitis or brain abscess. There was no significant difference in late complication rates between the sinus-preserving group and the sinus-obliterating group. The sinus obliteration procedure was not superior to the procedure of preservation of sinus with endoscopy to minimize late complications such as mucocele, meningitis or brain abscess.
Conclusion : Sinus preserving procedure with endoscopy for management of frontal sinus fracture enable to avoid the procedure consuming the efforts and time without increasing late complications.
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KEYWORD
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Frontal sinus fracture, Nasofrontal duct fracture, Maxillofacial trauma
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