Department of Otolaryngology -Head and Neck Surgery, University of California Davis, 2521 Stockton Boulevard, Suite 7200, Sacramento, CA 95817, USA.
Department of Otolaryngology-Head and Neck Surgery, University of Tennessee, 910 Madison Avenue, Suite 430, Memphis, TN 38103, USA.
Facial Plast Surg Clin North Am. 2022 Feb;30(1):71-83. doi: 10.1016/j.fsc.2021.08.006.
Although frontal sinus fractures are relatively uncommon, the potential for long-term morbidity is significant. Management strategies remain controversial due to a lack of strong clinical evidence. Despite a paucity of strong literature, a logical treatment algorithm is presented based on the structural integrity of three anatomic parameters: anterior table, frontal sinus outflow tract, and the posterior table/dura. The literature supports a paradigm shift from open surgical management to a more conservative treatment algorithm emphasizing observation and minimally invasive endoscopic techniques. Long-term follow-up for complex frontal sinus injuries is critical.
尽管额窦骨折相对少见,但长期发病的可能性很大。由于缺乏强有力的临床证据,管理策略仍存在争议。尽管文献很少,但根据三个解剖参数的结构完整性,提出了一个逻辑治疗算法:前板、额窦流出道和后板/硬脑膜。文献支持从开放式手术管理向更保守的治疗算法转变,强调观察和微创内镜技术。对复杂额窦损伤进行长期随访至关重要。