Gonty A A, Marciani R D, Adornato D C
Division of Oral and Maxillofacial Surgery, UKCD, Lexington, KY 40536, USA.
J Oral Maxillofac Surg. 1999 Apr;57(4):372-9; discussion 380-1. doi: 10.1016/s0278-2391(99)90270-7.
The purpose of this article is to provide an overview of fracture patterns, patient characteristics, and surgical approaches associated with frontal sinus fractures. The short- and long-term complications of frontal sinus fractures treated over a 20-year period are presented.
The records of patients admitted to the University of Kentucky Medical Center from 1975 through 1994 with a diagnosis of frontal sinus fracture were reviewed. Fracture patterns were categorized and information collected related to demographics, circumstance of injury, perioperative management, surgical procedures, and complications. Long-term complications were studied by asking patients to return for clinical and radiographic follow-up.
The average age of patients with frontal sinus fractures was 32 years. Thirty-one of the 33 victims were male. Motor vehicle accidents were the most common cause. Twenty-one patients had anterior table fractures (type I), 11 had combined anterior/posterior table fractures (type II = 9, type IV = 2), and one patient had an isolated posterior table fracture (type III). Short-term postoperative and perioperative complications were minimal. Long-term complications included acute frontal sinusitis (one patient), cosmetic forehead defects (two patients), and encephalitis (one patient).
The critical elements to successful frontal sinus fracture repair are precise diagnosis of the craniofacial fracture pattern, appropriate management of the frontonasal duct(s), and prevention of serious brain sequelae. Long-term follow-up of patients with frontal sinus injuries is recommended.
本文旨在概述与额窦骨折相关的骨折类型、患者特征及手术入路。文中呈现了20年间接受治疗的额窦骨折患者的短期和长期并发症情况。
回顾了1975年至1994年入住肯塔基大学医学中心且诊断为额窦骨折的患者记录。对骨折类型进行分类，并收集了与人口统计学、受伤情况、围手术期管理、手术操作及并发症相关的信息。通过要求患者返回进行临床和影像学随访来研究长期并发症。
额窦骨折患者的平均年龄为32岁。33名患者中有31名男性。机动车事故是最常见的致伤原因。21例患者为前壁骨折（I型），11例为前/后壁联合骨折（II型9例，IV型2例），1例患者为孤立的后壁骨折（III型）。术后短期及围手术期并发症极少。长期并发症包括急性额窦炎（1例患者）、前额部美容缺陷（2例患者）及脑炎（1例患者）。
成功修复额窦骨折的关键要素包括精确诊断颅面骨折类型、妥善处理鼻额管以及预防严重的脑部后遗症。建议对额窦损伤患者进行长期随访。
