Wallis A, Donald P J
Department of Otolaryngology, University of California-Davis, Sacramento 95817.
Laryngoscope. 1988 Jun;98(6 Pt 1):593-8. doi: 10.1288/00005537-198806000-00002.
A retrospective review is presented of 72 patients who sustained frontal sinus fractures (FSF) and were subsequently treated by the department of otolaryngology/head and neck surgery between the years of 1974 and 1986. Eighty-four percent of FSF occurred in males and 71% were a result of motor vehicle accidents. Only 24% remained conscious at the time of trauma, and in only one third of the cases was there no other fracture. Seventy-six percent of FSF involved both the anterior and posterior walls--a figure that possibly reflects the referral patterns to a hospital that is a major regional trauma center. Patients were treated with a variety of procedures including cranialization (42%), osteoplastic flap and fat obliteration (30%), open reduction and internal fixation of the anterior wall (20%), osteoplastic flap and sinus ablation (6%), and intersinus septectomy (1%). Some difficulty was encountered in documenting sustained follow-up, which ranged from 2 months to 9 years, and averaged 22 months. Nine percent of patients died in the post-trauma period. Minor complications were relatively common, but major complications occurred in only 10% of patients. Four patients (6%) suffered meningitis (although the portal of infection was not necessarily through the frontal sinus); one patient (1%) suffered severe pain over the sinus and forehead for at least 12 months after surgery; and a mucocele developed in four patients (6%).
本文对1974年至1986年间72例发生额窦骨折（FSF）并随后由耳鼻咽喉科/头颈外科治疗的患者进行了回顾性研究。84%的额窦骨折发生在男性患者中，71%是由机动车事故导致的。仅有24%的患者在受伤时仍保持清醒，且仅有三分之一的病例没有其他骨折。76%的额窦骨折累及前壁和后壁——这一数字可能反映了转诊至作为主要区域创伤中心的医院的模式。患者接受了多种治疗方法，包括颅骨化（42%）、骨成形瓣和脂肪填塞（30%）、前壁切开复位内固定（20%）、骨成形瓣和鼻窦切除（6%）以及鼻窦间鼻中隔切除术（1%）。在记录持续随访方面遇到了一些困难，随访时间从2个月到9年不等，平均为22个月。9%的患者在创伤后时期死亡。轻微并发症相对常见，但严重并发症仅发生在10%的患者中。4例患者（6%）发生脑膜炎（尽管感染途径不一定通过额窦）；1例患者（1%）在术后至少12个月内鼻窦和前额出现严重疼痛；4例患者（6%）出现黏液囊肿。
