University of Miami Miller School of Medicine.
Division of Plastic, Aesthetic, and Reconstructive Surgery, University of Miami, Miami, FL.
J Craniofac Surg. 2021 May 1;32(Suppl 3):1246-1250. doi: 10.1097/SCS.0000000000007623.
In spite of a long and tortuous history of the acute management of frontal sinus fractures, current optimal management remains steeped in controversy. These fractures are frequently produced by excessive forces and are often accompanied with other injuries. However, disruption of the nasofrontal duct persists as essential to maintain proper sinus function and should guide current management. Although there has never been any distinct procedure defining optimal outcomes, proper treatment is contingent on precise diagnosis culled from a complete history, physical examination, and imaging studies. This is further augmented by the surgeon's intraoperative findings. Reconstruction will ultimately rest on the degree of disruption of the anterior and posterior sinus walls, as well as the status and function of the nasofrontal ducts. For these reasons, current management continues to be challenging and evolving. Thus, this review will discuss the etiology and clinical presentation of frontal sinus fractures, the current complications arising in the subject, and the evolution of treatment options towards a more conservative and endoscopic approach to care.
尽管额窦骨折的急性处理有着漫长而曲折的历史，但目前的最佳处理方法仍然存在争议。这些骨折通常是由过大的外力引起的，常伴有其他损伤。然而，鼻额管的破裂仍然是保持鼻窦正常功能所必需的，应该指导目前的治疗。虽然从来没有任何明确的程序来定义最佳结果，但正确的治疗取决于从完整的病史、体格检查和影像学研究中得出的精确诊断。这进一步得到了外科医生术中发现的支持。重建最终将取决于前壁和后壁窦的破坏程度，以及鼻额管的状态和功能。基于这些原因，目前的管理仍然具有挑战性和不断发展。因此，这篇综述将讨论额窦骨折的病因和临床表现，目前该领域出现的并发症，以及治疗方法的演变，朝着更保守和内镜治疗的方向发展。
