Pollock Richard A, Hill Joseph L, Davenport Daniel L, Snow David C, Vasconez Henry C
Department of Surgery, University of Kentucky College of Medicine, Lexington, KY 40536, USA.
Ann Plast Surg. 2013 Jul;71(1):54-9. doi: 10.1097/SAP.0b013e3182468198.
Retrospective review of charts of 180 consecutive patients with frontal sinus fractures managed by plastic surgeons at the University of Kentucky between 1987 and 2007 was performed with institutional review board approval. Twenty-six charts did not meet the criteria. The remaining 154 records provided 1-to-20-year follow-up. The study included 34 patients who underwent cranialization and 120 patients who did not. A low-complication rate of 6% after cranialization is ascribed by the authors to meticulous sinus mucosal debridement; thorough obliteration of the frontal sinus outflow tract (with sterile gelatin sponge pledgets and bone chips from the outer cortex of the temporoparietal skull); and avoidance of avascular barriers, such as abdominal fat. As high-resolution computerized tomography with parasaggital views was introduced, an increasing ability to preoperatively define the extent of injury of the medial and lateral sinus floor was observed. The authors conclude selective use of cranialization is indicated.
在肯塔基大学机构审查委员会批准下，对1987年至2007年间由整形外科医生治疗的180例连续性额窦骨折患者的病历进行回顾性研究。26份病历不符合标准。其余154份记录提供了1至20年的随访。该研究包括34例行颅骨化手术的患者和120例未行颅骨化手术的患者。作者将颅骨化术后6%的低并发症发生率归因于细致的鼻窦黏膜清创；彻底闭塞额窦流出道（使用无菌明胶海绵小块和颞顶颅骨外皮质的骨屑）；以及避免使用无血管屏障，如腹部脂肪。随着引入具有矢状旁位视图的高分辨率计算机断层扫描，观察到术前界定内侧和外侧鼻窦底损伤范围的能力不断提高。作者得出结论，表明应选择性使用颅骨化手术。
