Strong E Bradley
Department of Otolaryngology, University of California, Davis School of Medicine, Sacramento, California.
Craniomaxillofac Trauma Reconstr. 2009 Oct;2(3):161-75. doi: 10.1055/s-0029-1234020.
Frontal sinus injuries may range from isolated anterior table fractures resulting in a simple aesthetic deformity to complex fractures involving the frontal recess, orbits, skull base, and intracranial contents. The risk of long-term morbidity can be significant. Optimal treatment strategies for the management of frontal sinus fractures remain controversial. However, it is critical to have a thorough understanding of frontal sinus anatomy as well as the current treatment strategies used to manage these injuries. A thorough physical exam and thin-cut, multiplanar (axial, coronal, and sagittal) computed tomography scan should be performed in all patients suspected of having a frontal sinus fracture. The most appropriate treatment strategy can be determined by assessing five anatomic parameters including the: frontal recess, anterior table integrity, posterior table integrity, dural integrity, and presence of a cerebrospinal fluid leak. A well thought out management strategy and meticulous surgical techniques are critical to success. The primary surgical goal is to provide a safe sinus while minimizing patient morbidity. This article offers an anatomically based treatment algorithm for the management of frontal sinus fractures and highlights the key steps to surgical repair.
额窦损伤的范围可能从仅导致简单美学畸形的孤立前壁骨折到涉及额隐窝、眼眶、颅底和颅内结构的复杂骨折。长期发病的风险可能很大。额窦骨折的最佳治疗策略仍存在争议。然而，全面了解额窦解剖结构以及目前用于处理这些损伤的治疗策略至关重要。所有疑似额窦骨折的患者均应进行全面的体格检查以及薄层多平面（轴位、冠状位和矢状位）计算机断层扫描。通过评估五个解剖参数可以确定最合适的治疗策略，这些参数包括：额隐窝、前壁完整性、后壁完整性、硬脑膜完整性以及脑脊液漏的存在情况。精心制定的管理策略和细致的手术技术是成功的关键。主要手术目标是提供一个安全的鼻窦，同时将患者的发病率降至最低。本文提供了一种基于解剖学的额窦骨折治疗算法，并强调了手术修复的关键步骤。
