Department of Otolaryngology, Texas Tech University Health Sciences Center School of Medicine, Lubbock, TX.
J Craniofac Surg. 2020 Nov/Dec;31(8):2240-2242. doi: 10.1097/SCS.0000000000006706.
Frontal sinus fractures require a large amount of force and often occur in the context of a major trauma. Many patients with these fractures are assessed in an emergent setting where stabilization takes precedence. Delayed diagnosis and treatment of a sinus fracture can result in life-threatening conditions, such as a cerebrospinal fluid (CSF) leak. A number of different treatment algorithms have been proposed, highlighting the complexity of frontal sinus fracture management. The goal of this study is to determine how patients with frontal sinus fractures were treated at Texas Tech University Health Sciences Center and what complications arose as a result of the fracture and subsequent management strategy. Over 9 years, there were 69 reported cases. A total of 63 of these occurred in males (91.3%) versus 6 (8.7%) in females. The majority occurred after a motor vehicle collision (MVC) or a motorcycle collision (MCC). A total of 51 cases were unilateral fractures and 18 were bilateral fractures. Five patients (7.2%) had CSF leakage and 64 (92.8%) did not have CSF leakage. One patient with CSF leakage (20.0%) was managed operatively. Of the 64 patients without CSF leakage, 4 (6.3%) were managed operatively. All operative patients were managed by cranialization. Complications included vision changes, facial pressure, anosmia, facial paresthesia, pneumocephalus, and mucus retention cysts. Vision changes were the most common complication. There did not appear to be any significant difference in complications between the CSF leakage groups, indicating that non-operative management remains a viable option in the management of frontal sinus fractures.
额窦骨折需要很大的力量，通常发生在重大创伤的情况下。许多患有这些骨折的患者在紧急情况下进行评估，在这种情况下，稳定是首要任务。额窦骨折的延迟诊断和治疗可能导致危及生命的情况，如脑脊液 (CSF) 漏。已经提出了许多不同的治疗算法，突出了额窦骨折管理的复杂性。本研究的目的是确定德克萨斯理工大学健康科学中心如何治疗额窦骨折患者，以及由于骨折和随后的管理策略而产生的哪些并发症。在 9 年多的时间里，报告了 69 例病例。总共 63 例发生在男性（91.3%），6 例发生在女性（8.7%）。大多数发生在机动车碰撞 (MVC) 或摩托车碰撞 (MCC) 之后。共有 51 例为单侧骨折，18 例为双侧骨折。5 例（7.2%）有 CSF 漏，64 例（92.8%）无 CSF 漏。1 例 CSF 漏患者（20.0%）接受手术治疗。在 64 例无 CSF 漏的患者中，有 4 例（6.3%）接受手术治疗。所有手术患者均采用颅化治疗。并发症包括视力变化、面部压力、嗅觉丧失、面部感觉异常、气颅和粘液潴留囊肿。视力变化是最常见的并发症。在 CSF 漏组之间，并发症似乎没有任何显著差异，这表明非手术治疗仍然是额窦骨折治疗的可行选择。
