ENT Department, Carol Davila University of Medicine and Pharmacy, 050472 Bucharest, Romania.
OMF Surgery Department, Bucharest Emergency University Hospital, 050098 Bucharest, Romania.
Medicina (Kaunas). 2022 Nov 30;58(12):1756. doi: 10.3390/medicina58121756.
Frontal bone trauma has an increasing incidence and prevalence due to the wide-scale use of personal mobility devices such as motorcycles, electric bicycles, and scooters. Usually, the patients are involved in high-velocity accidents and the resulting lesions could be life-threatening. Moreover, there are immediate and long-term aesthetic and functional deficits resulting from such pathology. The immediate complications range from local infections in the frontal sinus to infections propagating inside the central nervous system, or the presence of cerebrospinal fluid leaks and vision impairment. We review current trends and available guidelines regarding the management of cases with frontal bone trauma. Treatment options taken into consideration are a conservative attitude towards minor lesions or aggressive surgical management of complex fractures involving the anterior and posterior frontal sinus walls. We illustrate and propose different approaches in the management of cases with long-term complications after frontal bone trauma. The team attending to these patients should unite otorhinolaryngologists, neurosurgeons, ophthalmologists, and maxillofacial surgeons. Take-home message: Only such complex interdisciplinary teams of trained specialists can provide a higher standard of care for complex trauma cases and limit the possible exposure to further legal actions or even malpractice.
由于摩托车、电动自行车和滑板车等个人移动设备的广泛使用,额骨创伤的发病率和患病率不断上升。通常,患者会卷入高速事故,由此导致的损伤可能危及生命。此外,这种病理还会立即产生美观和功能上的缺陷,以及长期的影响。立即出现的并发症范围从额窦的局部感染到中枢神经系统内的感染传播,或存在脑脊液漏和视力损害。我们回顾了额骨创伤病例管理方面的当前趋势和可用指南。考虑的治疗选择包括对小病变采取保守态度,或对涉及前、后额窦壁的复杂骨折采取积极的手术治疗。我们展示并提出了额骨创伤后长期并发症病例的不同处理方法。治疗这些患者的团队应包括耳鼻喉科医生、神经外科医生、眼科医生和颌面外科医生。
只有这种由经过培训的专业人员组成的复杂跨学科团队,才能为复杂创伤病例提供更高标准的护理,并限制可能面临的进一步法律诉讼甚至医疗事故的风险。