Jing Xi Lin, Luce Edward
Department of Plastic Surgery, University of Tennessee Health Science Center, Memphis, Tennessee.
Craniomaxillofac Trauma Reconstr. 2019 Sep;12(3):241-248. doi: 10.1055/s-0038-1675560. Epub 2019 Feb 19.
Frontal sinus fractures are relatively rare maxillofacial injuries (only 5-15% of all facial fractures). The appropriate management of frontal sinus fracture and associated pathology is controversial. Diagnosis and treatment of frontal sinus fractures has improved with the advances of high-resolution computed tomography technology. Treatment of frontal sinus fractures depends on several factors, including contour deformity of anterior table; the presence of CSF leak or air-fluid level in the sinus, likelihood of nasofrontal duct obstruction, and degree of displacement of posterior table. Nasofrontal duct patency should be checked if fracture pattern is highly suspicious of ductal injury. Cranialization is performed in cases of severely comminuted posterior wall fracture. Long-term complication of frontal sinus fracture can occur up to 10 years after initial injury or intervention; so, judicious long-term follow-up is warranted. This article presents the management and complications of frontal sinus fractures.
额窦骨折是相对少见的颌面损伤(仅占所有面部骨折的5%-15%)。额窦骨折及相关病变的恰当处理存在争议。随着高分辨率计算机断层扫描技术的进步,额窦骨折的诊断和治疗已有改善。额窦骨折的治疗取决于多个因素,包括前壁的轮廓畸形;窦内脑脊液漏或气液平面的存在、鼻额管阻塞的可能性以及后壁的移位程度。如果骨折类型高度怀疑鼻额管损伤,应检查鼻额管通畅情况。对于严重粉碎性后壁骨折的病例,应进行颅骨化手术。额窦骨折的长期并发症可在初次受伤或干预后长达10年出现;因此,进行审慎的长期随访是必要的。本文介绍了额窦骨折的处理及并发症。