Sathyanarayanan R, Raghu K, Deepika S, Sarath K
Department of Oral and Maxillofacial Surgery, Indira Gandhi Institute of Dental Science, Sri Balaji Vidyapeeth (Deemed to be University), Puducherry, India.
Ann Maxillofac Surg. 2018 Jul-Dec;8(2):276-280. doi: 10.4103/ams.ams_187_18.
The purpose of the present study is to report an overview of fracture patterns and surgical approaches for 15 patients who were treated in our Indhira Gandhi Institute of Dental Sciences, Pondicherry, India from 2010 to 2015.
Fifteen people were included in the study, which were diagnosed with anterior table fracture of the frontal sinus and were randomly admitted in our institution. All patients were evaluated preoperatively with axial and coronal computed tomography scans before operating. The parameters used to classify the patients were age, mode of injury, associated injury, and details of fracture, surgical approaches, fixation, and conservative management.
Analysis of 15 patients based on parameters showed that the ages of patients varied between 22 and 36 years due to road traffic accident as the common etiology. There were associated fractures in the maxillofacial region seen in 11 patients and the rest were isolated frontal sinus fractures. Conservative management was opted in six patients and for others, surgical approach to the fracture site was done through existing laceration and by bicoronal approach. Three of the cases showed comminuted fracture of anterior and posterior table. The overall contour of the frontal bone was good in all the patients. None of the patients required any immediate reoperation or developed any delayed abscess or mucocele formation.
Decision-making regarding the best time to treat, the surgical approach and the technique depends on the severity and the extent of the fracture and associated complications. Our protocol was to follow up and observe the undisplaced fractures and operate anterior wall defects. If there was a fracture involvement of posterior frontal wall, treatment can be planned along with neurosurgical consultation and then operate depending on the associated complications.
本研究旨在报告2010年至2015年在印度本地治里英迪拉·甘地牙科学院接受治疗的15例患者的骨折类型及手术入路概况。
本研究纳入15例被诊断为额窦前壁骨折的患者，这些患者均随机入住我院。所有患者在手术前均接受了轴向和冠状位计算机断层扫描进行术前评估。用于对患者进行分类的参数包括年龄、受伤方式、合并伤、骨折细节、手术入路、固定方式以及保守治疗情况。
基于各项参数对15例患者的分析显示，患者年龄在22岁至36岁之间，常见病因是道路交通事故。11例患者存在颌面部合并骨折，其余为单纯额窦骨折。6例患者选择保守治疗，其余患者通过现有的撕裂伤和双冠状入路对骨折部位进行手术。3例患者显示前后壁粉碎性骨折。所有患者额骨的整体轮廓良好。所有患者均无需立即再次手术，也未出现任何延迟性脓肿或黏液囊肿形成。
关于最佳治疗时间、手术入路和技术的决策取决于骨折的严重程度和范围以及相关并发症。我们的方案是对无移位骨折进行随访观察，并对前壁缺损进行手术。如果额骨后壁骨折累及，可在神经外科会诊后制定治疗方案，然后根据相关并发症进行手术。
